Please complete the form below to request an appointment at our travel clinic. A member of our team will be in touch to set up an appointment and/or answer any questions you may have.
Please note: We cannot process emergency requests from this form. If you are having a medical emergency, please call 911.
When you submit this form, your information will be sent to the appropriate Middlesex Health staff, who will help you schedule an appointment or complete your request.
All fields are required unless otherwise noted.