Please complete the form below to request an appointment for your physical exam.

 

First Name    
     
Last Name    
     
Date of Birth    
     
E-mail Address    
     
 

Have you completed your wellness/biometric screening (height, weight, blood pressure, cholesterol, etc)?

      
   
   

Please choose your first, second and third preference for the date and general time frame when you would like your appointment scheduled.

     
First Preference  
     
Second Preference  
     
Third Preference     


Additional Comments


 

Quick Reference

Corporate Health Services

Phone 336-713-4666
Fax 336-721-3999

healthy@wakehealth.edu

Urgent Care - Clemmons

Phone 336-713-0555

Urgent Care - Mocksville

Phone 336-713-0400

Our Urgent Care clinics are available for Workers Compensation claims, physicals, pre-employment screenings and more.
Ways to Give
Comprehensive Cancer Centers National Designation is RenewedMagnet Hospital RecognitionConsumer Choice2015 Best DoctorsJoint Commission Report

Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

© Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157. All Rights Reserved.