Request an Appointment

Thank you for your interest in Vivent Health. Once you have completed and submitted the form below, a member of our scheduling team will contact you by phone in two business days to confirm your appointment.

We look forward to meeting you.

Select Service(s)
- Hepatitis C Testing
- Gonorrhea Testing
- Chlamydia Testing
- Syphilis Testing
- PrEP
- HIV Testing
Select a location*
Patient Information
First Name*
Last Name
Email
Phone*
Address
Street Address Address Line 2 City State ZIP Code
Patient Date of Birth*
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Were you referred to us by another physician?*
How did you learn about Vivent Health?*
Very briefly, please let us know your primary reason for scheduling an appointment.*
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Request an Appointment

We look forward to meeting you.

Patient Information