Full Name *

Phone Number *

Format: +254 7xx xxx xxx

Email Address

Service Needed * -- Select a service -- General Consultation Laboratory Tests Ultrasound Imaging Antenatal Care Family Planning Services Chronic Disease Management Wound Care & Treatment Immunization & Vaccination Other Services

Preferred Date *

Preferred Time *

Health Concern (Optional)

Do not include sensitive medical details here. Provide full medical info at the facility.

🔒 Data Protection Notice: Your data is used only for scheduling and care, in line with Kenya's Data Protection Act 2019. No third-party sharing without consent.

I consent to use of my contact details for appointment scheduling and healthcare purposes.

Insurance: SHA accepted. M-Pesa and cash also accepted. SHA status verified at registration.