Request an Appointment – Pregnancy Help Medical Clinics

Submitting this form is a request for an appointment, not a confirmed appointment. Once we receive your request, our team will review your information and contact you to confirm availability and schedule your appointment.

Enviar este formulario es una solicitud de cita, no una cita confirmada. Una vez que recibamos su solicitud, nuestro equipo revisará su información y se pondrá en contacto con usted para confirmar la disponibilidad y programar su cita.

Required fields marked with *.

*Preferred Language:*What was the first day of your last menstrual period?:*Please select a service: *Select the location most convenient for you:

Hialeah North Miami Kendall Flagler Homestead

*Select a date and a time range nearest to your preference: *First Name:*Last Name:*Date of Birth: We will contact you to schedule your appointment during our normal business hours.*Contact Preference: Phone Text Message*Phone:*May we identify ourselves when we contact you to schedule an appointment time? Yes No*How did you hear about our web site?: