Douglas County School System - School Based Health Center Appointment Request Form
Appointment Request Form
What school does your child attend?
Type of appointment
Mental Health Counseling
COVID-Testing or COVID Immunization
Thank you for requesting an appointment. A provider from our clinic will contact you to set up your appointment.
Our clinic can provide services that include: annual physicals, sports physicals immunizations, well-checks, sick visits, mental health screenings and services. We can also file your insurance, offer self pay options, and has a sliding fee scale based on income.
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This form was created inside of Douglas County School System.