Request an Appointment | Alternatives Medical Clinic (AMC)

Required field *

First name*

Last name*

Email

Consent to email

Yes
No

Phone Number*

Date of Birth*

Can we call as an unblocked number?

Yes
No

Consent to text message

Yes
No

Service*

Pregnancy Options
Abortion Education
Pregnancy Test
Ultrasound
STD Test
Sexual Health Education
Other

Consent if we can identify ourselves as Alternatives Medical Clinic*

Yes
No

How you heard about us?

Message

NOTE -- your appointment is a request and is not automatically added to our appointment book. We will confirm by phone a specific appointment time with you based on your preferences and our appointment availability.

CAPTCHA

Untitled

Appointments

We value your privacy. All services are Free and your information we receive is Confidential.