Request an Appointment

If you are not currently a patient at Vida Medical Clinic and Support Services and are interested in receiving care, we are here to help you!

Please call or text us at 920-731-4354 or submit an appointment request, and a nurse or staff member will contact you. 

Request an Appointment Form


This form does not guarantee an appointment. A Vida nurse will be in contact with you upon submission of this form to schedule an appointment. All services are free.