Appointment with a primary care doctor

To request the exam, you need to register and provide the following information.

Please complete in the form the aspects that apply to your case.

When was your last physical exam? *
Do you have or suspect you have a disease or medical condition? *
If yes, please elaborate
Do you have any symptoms that worry you:
Nota: "Sharing the Hope" Community Wellness health Fair will facilitate access to reduced cost consultation with a primary care doctor if needed.

You do not have access to make this request. You must log in or register if you do not have an account.

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