Appointment Request

Do you have questions about First Care Clinic? Would you like an appointment? Please fill out the appointment request form below or text us at 608-259-1605. We’ll get back to you during normal business hours by phone, email or text. Let us know which you prefer.

To speak with someone immediately, please call our 24/7 phone line at 608-259-1605.

First Name

Last Name

How would you like us to contact you?

Applicable contact information (phone or email)

Type of appointment requested

Preferred day(s) for appointment
MondayTuesdayWednesdayThursdayFriday

Preferred time for appointment

Your message or question. If you are seeking an appointment for a pregnancy test, please provide the date of your last menstrual period.

Please note: We provide STI testing and treatment for women only.

For Your Confidentiality: In granting us permission to reply to your email, please consider the confidentiality of any reply that you may receive. If you are giving us permission to call you, will there be anyone else who may answer the phone call? Does anyone else have access to your email? Does anyone else check your phone for text messages? If there are special confidentiality concerns we need to be aware of in responding, please spell them out above so we may be sensitive to your needs.