Request an Appointment at Circle Care Center
Use the form below to request an appointment at Circle Care Center. Please note that all appointment requests will be confirmed by our staff within 1-2 business days. If you need a same-day or next-day appointment, please give us a call at 203-852-9525. **If you are experiencing a medical emergency please call 911.**
Name
*
First Name
Middle Name
Last Name
Legal Name (If different from above)
First Name
Middle Name
Last Name
Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Are you currently a patient at Circle Care Center?
*
Yes, I am a current patient.
No, I am a new patient.
No, I am a returning patient.
Which of our providers are you requesting an appointment with?
Dr. David S. Rubin, MD, FACP, AAHIVS
Dr. Trish Garton, DNP, AAHIVS
Ed Moran, LCSW
No Preference
What is the reason for your visit?
*
Primary Care/Annual Physical
Diagnostic Appointment (Are you feeling ill?)
Sexual Health/STI Testing and Treatment
HIV Treatment
HIV Prevention (PrEP & PEP)
Gender Affirming Care/HRT
Behavioral Health (Counseling)
Vaccine (Covid Booster and/or Flu Shot)
MPOX Vaccine
Other
What days/times work best for you?
Please note that our clinical hours are Monday 9am - 7pm, Tuesday - Thursday, 9am - 5pm, Friday, 9am - 4pm.
Submit
Should be Empty: