GatorWell Health Promotion Services
Request an Individual Appointment
Use this form to request of one the following individual service appointments: Wellness Coaching for Academic Success, HIV Counseling and Testing, Quit Tobacco Program or Health Topic consultations.
Once the form is complete, GatorWell will contact you to find a time and place to meet with a health educator that best suits your schedule.
All information captured on this form is confidential.
If you have problems with this form, please email firstname.lastname@example.org
UF Student ID Number:
Email (most frequently used)
Preferred form of communication:
Select the service for which you are interested in making an appointment?
Wellness Coaching for Academic Success
HIV Counseling and Testing
Quit Tobacco Program
Alcohol and/or Other Drug Consultation
Sexual Health Consultation
Birth Control Options Consultation
Have you used this service before?
Who did you meet for this service?
Scheduling: In order to find a time that works with your schedule, please describe your typical availability during the week.
**Ex. Tuesday between 9a-12p, Thursday between 1p-4p, Friday after 12p, etc.**
***HIV TESTING HOURS: Mon: 2p-4:30p, Wed: 2p-4:30p and Thur/Fri: 9:30a-11:30a***
Do Not Fill This Out