Skip to main content
URMC / Deaf Wellness Center / Clinical Services / Evaluation and Psychotherapy / Deaf Wellness Clinic Contact Form

Deaf Wellness Clinic Contact Form

Appointment Request

Please complete the secure form below to request a non-urgent appointment. We will contact you within two business days to schedule your appointment.

Online Appointment Request Terms of Use

By agreeing to the terms of our Online Appointment Request form, you will enter a secure area of our site. URMC Deaf Wellness Center will not be held responsible in the event your electronic message is not transmitted due to technical problems related to this site or to the hosting server. All personal identifying information is encrypted and your message will not be internally or externally forwarded to other third parties.

We will respond to your request within two business days (holidays excluded), Monday - Friday. If you do not hear from us within that timeframe or should have any questions regarding your appointment request or this online form, please contact us by phone.

If you do not accept the terms of this disclaimer, you will not be able to process your appointment request online.

Disclaimer Agree to continue: