Online Appointment Form

Gresham School-Based Health Center

Fill the form below to request an appointment. We will get back to confirm and plan your appointment.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Have you been to our facility before?*

YesNo
Preferred method of contact?*

TextEmail
Which school do you attend?*

Gresham HSBarlow HSREY/FLEX
Phone Number
Which service do you want to make an appointment for?*
Email
do not use school email address
Reason For Visit
Type a question
Preferred Appointment Date *
Should be Empty: