Inquire About an Appointment

Please provide some information about the services you are seeking at the GW Center Clinic and how we might get in touch with you. The information will be reviewed by clinic staff and student-clinicians working in the clinic under supervision.

Providing information on this form is voluntary. While those working in our clinic are trained to keep information private and seek to protect confidentiality, if you prefer to contact us by phone, please leave a message at 202-994‐4937.

Providing information to this form does not indicate that you are entering into a clinical relationship with one of our student-clinicians and this is not a guarantee that we are the best fit to provide services. We will review this information and contact you in the method that you indicate.

This form should not be used in the event of a clinical emergency as contact is not reviewed immediately or when the clinic is closed. If you are experiencing a clinical emergency please dial 988 or 911 for immediate assistance.


 

I am seeking services for:
My name
Services sought: