Making an appointment is easy. You can complete the form below or you can call our appointment desk at
(334)660-5872.
Name:
Mailing Address:
Daytime Phone Number:
Email Address:
Most Convenient Day For Your Appointment:
(clinics are held every Thursday)
Select a Date
May 17
May 24
May 31
June 07
June 14
June 21
June 28
July 05
July 12
July 19
July 26
August 02
August 09
August 16
August 23
August 30
September 06
September 13
September 20
September 27
October 04
October 11
October 18
October 25
November 01
November 08
November 15
November 22
November 29
December 06
December 13
December 20
December 27
Itinerary * List in chronological order the countries you are visiting:
1.)
2.)
3.)
4.)
5.)
Locale:
City
Rural Area
Jungle
Mountains
Other
Departure Date:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2001
2002
2003
2004
2005
Length of Stay:
Nature of Trip:
Select One
Pleasure
Business
Mission
Other
Is this your first visit to USA Travelers' Health Center:
Yes
No
How did you learn about the USA Travelers' Health Center:
Select One
Friend/Family
Newspaper
Magazine
Television
Radio
Mail
Internet Search
Comments:
Back to Travelers' Health Home
University of South Alabama
-
Mobile, AL 36688-0002 / (334) 460-6101
For comments or questions about our Web site, please
Contact Us
URL: http://www.southalabama.edu/travelershealth/appointment.html
