Request An Appointment
Ready to Get Prepared?
Whether you're preparing for a trip, working through a school or workplace form, looking for a specific vaccine, or simply not sure where to start — fill out the inquiry form below and our team will review your request before confirming your appointment.
No appointment is confirmed until JEMA contacts you directly.
What Happens After You Submit:
01
You Send Your Request.
Fill in your contact details, what service you think you need, and your preferred timing. If you're not sure which service applies to your situation, choose the closest option and add a note.
02
JEMA Reviews Your Information.
Our team looks at what you've submitted and determines the right appointment type, timing, and any additional details we may need from you.
03
We Contact You to Confirm.
We'll reach out by your preferred contact method to confirm your appointment. At that point, we'll gather any clinical information needed through our secure booking system.
This Is an Inquiry Form, Not a Clinical Intake Form.
Please do not include personal health information — such as medical conditions, medications, allergies, or vaccine history — in this form.
☝️ This form is not transmitted or stored through a secure health records system and is not subject to PHIA protections.
Once your appointment is confirmed, JEMA will collect the clinical information we need through our secure system before your visit.
Not Sure Which Service to Select?
Choose the closest option and leave us a note. You can also contact JEMA before submitting if you'd prefer to talk it through first — we're happy to help you figure out the right appointment type before you book.