top of page
Absolute Care Logo.png

Request an Appointment

Please fill out the form below and a member of our team will reach out to confirm your appointment!

Date of Birth
Month
Day
Year
Preferred Contact Method
Cell
Text
Email
How Can We Help? Check all that apply
Are You Currently Receiving Services Elsewhere?
Yes
No
Do You Have Medicaid or Other Insurance
Yes - Medicaid
Yes - Other Insurance
No
How Would You Like To Be Seen?
In-person (Baltimore)
In-person (Hyattsville)
Virtual (Telehealth)
No Preference
Preferred Appointment Days
Preferred Appointment Time
bottom of page