Appointment with a Specialist

To request the exam, you need to register and provide the following information.
Please complete this short form to request your exam.
Choose the reasons or symptoms that apply to you, and share any other details that may help us understand your needs.

Have you been diagnosed with an illness that requires you to see a specialist? *
If yes, please elaborate

Have you seen a specialist for this condition? *
**Individuals whose results for any exam offered through the “ Sharing the Hope” Community Wellness health Fair are positive or abnormal, will have access to reduced cost consultation with a specialist

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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Appointment with a primary care doctor