Request an Appointment

SHS General Clinic Women's Clinic Request an Appointment Appointment FAQs SHS Clinic Forms

Request an Appointment

SCHEDULING APPOINTMENTS

To schedule an appointment, call (813) 974-2331 or complete the Online Appointment Request Form below. Same day appointments (if available) can only be requested by calling; the online form is for future appointment requests only.

ONLINE APPOINTMENT REQUEST FORM:
Please fill out the fields on this form and include the information requested below in the Questions/Comments box (the last box). We cannot schedule an appointment time for you without this information. A representative will contact you in approximately 1-2 business days after you submit this form.

Date of Birth
Insurance (Yes or No)
Appointment Day Preference
Appointment Time Preference
Reason for the Appointment
"Females only" If requesting a yearly woman's exam please indicate day, month, and year of last exam.
Have you been to the Clinic before? If Yes, was it before January 2009?

* Indicates Required Field

*First Name:
*Last Name:
Student ID# (U1234-5678):
Address:
City:
State:
Zip:
Phone Number:
*Email Address:
Question/Comments:

Request an Appointment Form

NOTE: This contact form is for general health questions only and should NOT be used for ANY patient-specific questions. Patient-specific questions may not receive a response.

These inquiries are not monitored on a daily basis. Please note that medical staff at Student Health Services are not permitted to comment on specifics of medical treatment and diagnosis over the computer. E-mail / the internet is not a confidential mode of communication and it is inappropriate for conveying information of an urgent nature to and from medical providers. E-mail / the internet is not a replacement for direct, face-to-face contact with a provider. You are strongly urged to pursue health matters by telephoning your provider or making an appointment at Student Health Services @ 813-974-2331.
E-mail Disclaimer:
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. Section 668.6076, F.S.