WTL Health Clinic Pre-Appointment Form

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WTL Health Clinic Pre-Appointment Form

Due to the current COVID-19 pandemic, WTL Health Clinic has suspended walk-in services. We are able to offer limited in-person services by appointment only. By continuing to the next section, you are confirming that you do not have a current medical emergency.

PLEASE NOTE: If you are experiencing a medical emergency, call 911. If you are in Rhode Island and have questions regarding COVID-19, call the Rhode Island Department of Health's hotline at 401-222-8022 or dial 211 outside of normal business hours.

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PATIENT CONTACT INFORMATION

Last Name *

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First Name *

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Preferred phone number *

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Email address

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