Attach a copy of patient's ID (.jpg, .pdf, .doc, .docx – less than 10 MB in size):
Request An Appointment
Thank you for using the online request form for an appointment at Clemenceau Medical Center outpatient clinics. This is a secure area. The information you enter and submit is confidential. Your request cannot be processed unless all the below fields are completed.
Our Patient Service Coordinator will call you between 8h30 a.m. and 5h30 p.m. (excluding weekends and holidays), to collect additional information and process your request.
FILL THE FORM BELOW TO REQUEST AN APPOINTMENT
Fields marked with * are required