Schedule an Appointment

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Schedule an Appointment Today

Call our office today to schedule your appointment: (760) 741-1224

OR fill out the questionnaire below for a call back.

Let us know what day and time you prefer so we can try to best fit your schedule.

Please indicate if you need medical fee assistance.

Our clinic is centrally located in Escondido:

362 W Mission Ave Suite 105
Escondido, CA 92025

We offer remote visits for your convenience: Telehealth Visit Information

Your personal information is protected in accordance with HIPAA standards.

Schedule an appointment at COLFS Locations Escondido-Mission Valley

Are you a new patient? *

Yes
No (I am an existing patient)

Date of Birth

Do you currently have insurance? *

Who is your insurance provider? *

Do you need copay / deductible assistance?

Do you need medical fee assistance?

Would you like an Office visit or a Telehealth visit *

Office visit
Telehealth visit

Select Reason for Visit *

Primary Care Services
Pediatric Services
Women’s Wellness
Prenatal Services
Pregnancy Test
Ultrasound Exam
Abortion Consultation
Abortion Pill Rescue
STD Testing
Fertility Services
Follow up
Physical/Annual Visit
Support Services
Vaccination Service
Other

What was the first day of your last period?

What kind support services are you interested in?

What is your reason for requesting an appointment? *

Preferred Date / Time (Office Will Confirm)?

Date

Time

Name *

First

Last

Phone *

Email *

Confirm Email

How did you hear about us? *

Web Search
Social Media
Referred by family or friend
Referred by another provider
Referred by Insurance
On-site signage
Community outreach
Email
Other

Comment or Message

Comment

Office Hours

Mon-Fri 9AM to 5PM, Sat AM

Request Appointment

362 W Mission Ave Suite 105
Escondido, CA 92025

(760) 741-1224

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