Make an Appointment Make an Appointment Full Name* Date of Birth* Best Method of Contact* Please list a phone number or email address for our representatives to contact you soon. Phone numbers are preferred! Have you been seen at an Equal Access Clinic before?* Yes No I am not sure Appointment Type* Sick Visit Chronic Medical Condition Management (including prescription refills) Annual Exam Hospital Follow Up Speciality Clinic: LGBTQ Night Speciality Clinic: Women's Night Please select the type of appointment that best describes how we can help you.Please tell us more about the reason for your visit.Which hospital were you treated at?* Please call the hospital you were treated at (including UF Health) and ask them to fax records to our clinic at 352-627-4141.Women's Night Concern* Routine Pap Smear Preferred Clinic for Appointment* No Preference Eastside Clinic (Tuesday Evening) Main Street (Thursday Evening) EACN currently has two primary care clinics that provide appointments. These clinics also offer specialty nights which may be more appropriate for your concerns. Is there a specific Medical Student you would like to follow up with?* Yes No Which Medical Student would you like to see?* Patrick Bliven, MS4 Michael Dangl, MS4 Jared Freitas, MS4 Erika Wert, MS4 Katelyn Carty, MS2 Jack Curtis, MS2 Mary Ann Smith, MS2 Daniela Ramirez, MS2 Cabbar Dundar, MS2 Kelsey Williamson, MS2 We will do our best to pair you with them to ensure continuity of care but cannot guarantee that they will be available. Please note that this option is currently only available at our Eastside location.NameThis field is for validation purposes and should be left unchanged.