Finger Lakes Health
Request an Appointment
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Request an Appointment

Welcome to the Dundee Family Health Center.

Please fill out the form below to request an appointment with one of our providers. We are scheduling from this form at least 2 weeks or more in advance. Please call your doctor's office if you need a more timely appointment.

Do not use this form if you need an urgent appointment or one within the next 2 weeks.

In case of emergency, call 911.

* Indicates required information
Patient's First Name * 
Patient's Last Name * 
Date of Birth (MM/DD/YYYY) * 
Contact Person (if other than Patient) 
Daytime Phone * 
Evening Phone 
Email Address * 
Appointment Day/Time Preferences * 
Reason for Visit * 
Are you a new patient with this office? * 

Authentication * 

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