Please complete the form below to submit a request for an appointment with the North Shore Health Department. Be sure to complete all the blanks on the form. Note: submitting this form does not guarantee you an appointment, but issues a request to us. You will receive a personal confirmation by email and/or phone when your appointment is scheduled. ***COVID-19 tests & vaccines not available via e-request*** We do not conduct COVID-19 testing at NSHD. We are not taking COVID-19 vaccination e-appointment requests at this time. Testing options in Milwaukee County: COVID-19 Testing Sites - IMPACT Inc.
eAppointment Request First NameLast NamePatient Name Daytime PhoneAddressCityEmail AddressDate of BirthAppointment Reason / ClinicAppointment Date/Time DesiredOther Notes / Comments Captcha : 1+2=? Answer