***If this is a medical or mental health EMERGENCY, or if you have been the victim of a crime, PLEASE DIAL 911 OR VISIT THE NEAREST EMERGENCY ROOM.***

This form is to schedule a Rainbow Clinic Appointment on 09/14! The clinic will be held at the Rardin Family Practice Center at 2231 N High St, Columbus, OH 43201.

Thank you for choosing CFC for your primary healthcare needs! Please complete this form if you have NEVER BEEN SEEN AT CFC.

Please fill out this form to request an appointment for THURSDAY NIGHT (5:45pm~8:30pm) for either an in-person or telehealth visit. With your permission, we will text or call you on Wednesday to tell you your appointment time & format.

If you have an in-person appointment, we will call to make sure you don't have any COVID-19 symptoms or recent COVID-19 exposure. Please note that patients with symptoms or recent exposure cannot be seen in-person. We thank you in advance for complying with our check-in process and clinic flow.

If the form does not work or you don't get a phone call, that means all appointments are full for the week. Please try again Friday morning. Additionally, please fill out the form ONLY ONE time each week. Filling it out more than once causes confusion and will not increase your chance of getting an appointment.

**** Unfortunately, we are not able to offer testing or treatment for COVID-19. If you're concerned about your symptoms or need such services, please call the Ohio Department of Health's COVID-19 hotline number at 1-833-427-5634 between 9 AM-8 PM or visit https://coronavirus.ohio.gov/wps/portal/gov/covid-19/home. ****
**** Desafortunadamente, no podemos ofrecer servicios de exámenes o de tratamiento para el coronavirus. Si usted sospecha síntomas de esta enfermedad, por favor comuníquese directamente con Ohio Department of Health para COVID-19 al 1-833-427-5634 entre 9 AM a 8 PM o visite https://coronavirus.ohio.gov/wps/portal/gov/covid-19/home. ****