Request an Appointment

Patient Information

Please provide the requested information about the individual that is requesting an appointment.
Patient Name *

First Name Last Name
Phone Number *
Email *
Zip Code
Language *

Appointment Type

Please select the service an appointment is needed for. If you need to see multiple service providers, our scheduling specialist will help when they call to confirm your appointment. NOTE: Dental appointments can only be made by phone.
Service *
Patient Status *
I'd like to also schedule an appointment for

Family Medicine Pediatrics OB/GYN Behavioral Health Optometry Other
After submission of your appointment request, you will be redirected to our New Patient Intake Form. All new patients are required to complete this form before being seen by a Community Health Centers provider.

Appointment Day and Time

Please select times that work for your availability. We will do our best to accommodate your needs.
1. Preferred Day *
1. Preferred Time *
2. Preferred Day
2. Preferred Time
Should be Empty:

Patient Information