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Request An Appointment

Thank you for choosing us for your healthcare needs! Please complete the form below so we can connect you with your healthcare team.

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Name
Best phone number to reach you.
Please select the option that best fits your request for an appointment.
Please identify the provider you would like to see if you know the name, or describe the type of visit you would like our scheduling team to discuss with you.
By providing my phone number to Wickenburg Community Hospital & Clinics (WCH), I agree and acknowledge that WCH may send text messages to my wireless phone number for any purpose. Message and data rates may apply. Message frequency will vary, and you will be able to Opt-out by replying ‚ÄúSTOP”, assistance can be found by texting “HELP”.PRIVACY POLICY: No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.