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 336-713-4696
Fax 336-713-7770

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
Five Wake Forest Baptist Specialties Earn U.S. News RankingsComprehensive Cancer Centers National Designation is RenewedMagnet Hospital Recognition2015 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.

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