Online Services & Appointment RequestGo Back
Note: If you are experiencing an emergency, please dial 911 to contact local emergency response personnel or 211 if you are a resident of La Crosse County, Wisconsin for the crisis line.
Please be assured that this online appointment request is a secured and confidential area and that information entered and submitted is confidential.
You may also contact us by phone through our Appointment Information Desk at 608-785-7000 x221.
Fields marked with an * are required fields; your request cannot be processed unless these fields are completed.
Attention: If you are not the intended client (person receiving services), please be sure to fill this form out with the appropriate client information.