{"id":21325,"date":"2026-06-01T20:35:32","date_gmt":"2026-06-02T00:35:32","guid":{"rendered":"https:\/\/pickawaycountypublichealth.org\/site\/pchd-staging\/?page_id=21325"},"modified":"2026-06-24T23:12:44","modified_gmt":"2026-06-25T03:12:44","slug":"appointment","status":"publish","type":"page","link":"https:\/\/pickawaycountypublichealth.org\/site\/appointment\/","title":{"rendered":"Appointment"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"21325\" class=\"elementor elementor-21325\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-da26410 e-con e-atomic-element e-flexbox-base e-da26410-92bdfdd \" data-id=\"da26410\" data-element_type=\"e-flexbox\" data-e-type=\"e-flexbox\" data-interaction-id=\"da26410\" data-e-type=\"e-flexbox\" data-id=\"da26410\">\n    \t\t\t<h2 data-interaction-id=\"01e483a\" class=\"e-01e483a-fa44d03 e-heading-base\" data-e-type=\"widget\" data-id=\"01e483a\">Request an Appointment<\/h2>\n\t\t\t\t\t<p class=\"e-34341e1-59e5dda e-paragraph-base\" data-interaction-id=\"34341e1\" data-e-type=\"widget\" data-id=\"34341e1\">Pickaway County Public Health<\/p>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-05853bb e-con e-atomic-element e-flexbox-base e-05853bb-e64025e \" data-id=\"05853bb\" data-element_type=\"e-flexbox\" data-e-type=\"e-flexbox\" data-interaction-id=\"05853bb\" data-e-type=\"e-flexbox\" data-id=\"05853bb\">\n    \t\t<div class=\"elementor-element elementor-element-dc4e3cb elementor-widget elementor-widget-text-editor\" data-id=\"dc4e3cb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Please Note:<\/strong>\u00a0Submitting this form is a request only and does not guarantee an appointment. A staff member will contact you to discuss availability and confirm scheduling. While walk-ins are welcome for many services, scheduling in advance or calling ahead is strongly encouraged to help minimize wait times and ensure staff availability.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\n<\/div>\n<div class=\"elementor-element elementor-element-c6f42f2 e-flex e-con-boxed e-con e-parent\" data-id=\"c6f42f2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c5cb98a elementor-widget__width-inherit elementor-widget elementor-widget-formidable\" data-id=\"c5cb98a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"formidable.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"frm_forms  with_frm_style frm_style_classic-blue2\" id=\"frm_form_21_container\" data-token=\"17386b7ef786b643bdaa16669a289a35\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_doctor-visit\" data-token=\"17386b7ef786b643bdaa16669a289a35\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Doctor Visit<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"21\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_21\" id=\"frm_hide_fields_21\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"doctor-visit\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_21\" name=\"frm_submit_entry_21\" value=\"3cf9eca79b\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/site\/wp-json\/wp\/v2\/pages\/21325\" \/><div id=\"frm_field_373_container\" class=\"frm_form_field frm_section_heading form-field  frm12 frm_first\">\n<h3 class=\"frm_pos_top frm_section_spacing\">Contact Information<\/h3>\n\n\n<div id=\"frm_field_377_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\n    <div id=\"field_7zilg_label\" class=\"frm_primary_label\">Name\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n    <\/div>\n    <fieldset aria-labelledby=\"field_7zilg_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tName\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_377\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_377-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_7zilg_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst Name\t\t\t\t<\/label>\n\n\t\t\t\t<input  type=\"text\" id=\"field_7zilg_first\" value=\"\" name=\"item_meta[377][first]\" autocomplete=\"given-name\" data-sectionid=\"373\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"  \/><div class=\"frm_description\" id=\"frm_field_377_first_desc\">First Name<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_377-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_7zilg_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast Name\t\t\t\t<\/label>\n\n\t\t\t\t<input  type=\"text\" id=\"field_7zilg_last\" value=\"\" name=\"item_meta[377][last]\" autocomplete=\"family-name\" data-sectionid=\"373\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"  \/><div class=\"frm_description\" id=\"frm_field_377_last_desc\">Last Name<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\n    \n    \n<\/div>\n<div id=\"frm_field_381_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\n    <label for=\"field_c7eu1\" id=\"field_c7eu1_label\" class=\"frm_primary_label\">Phone Number\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n    <\/label>\n    <input type=\"tel\" id=\"field_c7eu1\" name=\"item_meta[381]\" value=\"\"  data-sectionid=\"373\"  data-frmmask=\"(000)-000-0000\" placeholder=\"(999)-999-9999\" data-reqmsg=\"Phone Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone is invalid\" aria-invalid=\"false\" pattern=\"\\(\\d\\d\\d\\)-\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\n    \n    \n<\/div>\n<div id=\"frm_field_382_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n    <label for=\"field_xozjz\" id=\"field_xozjz_label\" class=\"frm_primary_label\">Email address\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n    <\/label>\n    <input type=\"email\" id=\"field_xozjz\" name=\"item_meta[382]\" value=\"\"  data-sectionid=\"373\"  placeholder=\"example@site.com\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\n    \n    \n<\/div>\n<div id=\"frm_field_379_container\" class=\"frm_form_field form-field  frm_top_container frm12 frm_first\">\n    <label for=\"field_9wjou\" id=\"field_9wjou_label\" class=\"frm_primary_label\">Date of Birth (If Applicable)\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n    <\/label>\n    <input type=\"text\" id=\"field_9wjou\" name=\"item_meta[379]\" value=\"\"  data-sectionid=\"373\"  maxlength=\"10\" placeholder=\"mm\/dd\/yyyy\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\n    \n    \n<\/div>\n<\/div>\n<div id=\"frm_field_385_container\" class=\"frm_form_field frm_section_heading form-field \">\n<h3 class=\"frm_pos_top frm_section_spacing\">Service Requested<\/h3>\n\n\n<div id=\"frm_field_395_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\n\t<label for=\"field_ufojr\" id=\"field_ufojr_label\" class=\"frm_primary_label\">Dropdown\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n\t<\/label>\n\t\t\t<select name=\"item_meta[395]\" id=\"field_ufojr\"  data-sectionid=\"385\"  data-placeholder=\"Select\"  placeholder=\"Select\" data-reqmsg=\"Dropdown cannot be blank.\" aria-required=\"true\" data-invmsg=\"Dropdown is invalid\" aria-invalid=\"false\"  >\n\t\t<option  class=\"frm-select-placeholder\" value=\"\" data-placeholder=\"true\">Select<\/option><option  value=\"Pregnancy Testing\">Pregnancy Testing<\/option><option  value=\"Lice Checks\">Lice Checks<\/option><option  value=\"Safe Sleep Education\">Safe Sleep Education<\/option><option  value=\"Blood Pressure Screening\">Blood Pressure Screening<\/option><option  value=\"Tobacco Cessation Education\">Tobacco Cessation Education<\/option><option  value=\"Individual Immunization Appointments\">Individual Immunization Appointments<\/option><option  value=\"Group Immunization Clinics (Offsite\/Mobile Unit)\">Group Immunization Clinics (Offsite\/Mobile Unit)<\/option><option  value=\"STI Testing (currently not available)\">STI Testing (currently not available)<\/option><option  value=\"CPR Training (currently not available)\">CPR Training (currently not available)<\/option><option  value=\"Vision Screening\">Vision Screening<\/option><option  value=\"Hidden in Plain Sight Program\">Hidden in Plain Sight Program<\/option><option  value=\"Safe Driving Education\">Safe Driving Education<\/option><option  value=\"Substance Abuse Education and Referral Services\">Substance Abuse Education and Referral Services<\/option><option  value=\"Narcan Education\/Distribution\">Narcan Education\/Distribution<\/option>\t<\/select>\n\t\n\t\n\t\n<\/div>\n<\/div>\n<div id=\"frm_field_404_container\" class=\"frm_form_field frm_section_heading form-field  frm12\">\n<h3 class=\"frm_pos_top frm_section_spacing\">Preferred Appointment Information<\/h3>\n\n\n<div id=\"frm_field_408_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\n\t<label for=\"field_u207w\" id=\"field_u207w_label\" class=\"frm_primary_label\">Preferred Date\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_u207w\" name=\"item_meta[408]\" value=\"\"  data-sectionid=\"404\"  maxlength=\"10\" data-invmsg=\"Preferred Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_409_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n\t<div  id=\"field_ch38a_label\" class=\"frm_primary_label\">Preferred Time\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<select aria-labelledby=\"field_ch38a_label\" name=\"item_meta[409]\" id=\"field_ch38a\"  data-sectionid=\"404\"  data-invmsg=\"Preferred Time is invalid\" class=\"auto_width\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12:00 AM\" >12:00 AM<\/option><option value=\"12:30 AM\" >12:30 AM<\/option><option value=\"1:00 AM\" >1:00 AM<\/option><option value=\"1:30 AM\" >1:30 AM<\/option><option value=\"2:00 AM\" >2:00 AM<\/option><option value=\"2:30 AM\" >2:30 AM<\/option><option value=\"3:00 AM\" >3:00 AM<\/option><option value=\"3:30 AM\" >3:30 AM<\/option><option value=\"4:00 AM\" >4:00 AM<\/option><option value=\"4:30 AM\" >4:30 AM<\/option><option value=\"5:00 AM\" >5:00 AM<\/option><option value=\"5:30 AM\" >5:30 AM<\/option><option value=\"6:00 AM\" >6:00 AM<\/option><option value=\"6:30 AM\" >6:30 AM<\/option><option value=\"7:00 AM\" >7:00 AM<\/option><option value=\"7:30 AM\" >7:30 AM<\/option><option value=\"8:00 AM\" >8:00 AM<\/option><option value=\"8:30 AM\" >8:30 AM<\/option><option value=\"9:00 AM\" >9:00 AM<\/option><option value=\"9:30 AM\" >9:30 AM<\/option><option value=\"10:00 AM\" >10:00 AM<\/option><option value=\"10:30 AM\" >10:30 AM<\/option><option value=\"11:00 AM\" >11:00 AM<\/option><option value=\"11:30 AM\" >11:30 AM<\/option><option value=\"12:00 PM\" >12:00 PM<\/option><option value=\"12:30 PM\" >12:30 PM<\/option><option value=\"1:00 PM\" >1:00 PM<\/option><option value=\"1:30 PM\" >1:30 PM<\/option><option value=\"2:00 PM\" >2:00 PM<\/option><option value=\"2:30 PM\" >2:30 PM<\/option><option value=\"3:00 PM\" >3:00 PM<\/option><option value=\"3:30 PM\" >3:30 PM<\/option><option value=\"4:00 PM\" >4:00 PM<\/option><option value=\"4:30 PM\" >4:30 PM<\/option><option value=\"5:00 PM\" >5:00 PM<\/option><option value=\"5:30 PM\" >5:30 PM<\/option><option value=\"6:00 PM\" >6:00 PM<\/option><option value=\"6:30 PM\" >6:30 PM<\/option><option value=\"7:00 PM\" >7:00 PM<\/option><option value=\"7:30 PM\" >7:30 PM<\/option><option value=\"8:00 PM\" >8:00 PM<\/option><option value=\"8:30 PM\" >8:30 PM<\/option><option value=\"9:00 PM\" >9:00 PM<\/option><option value=\"9:30 PM\" >9:30 PM<\/option><option value=\"10:00 PM\" >10:00 PM<\/option><option value=\"10:30 PM\" >10:30 PM<\/option><option value=\"11:00 PM\" >11:00 PM<\/option><option value=\"11:30 PM\" >11:30 PM<\/option><\/select>\n\t\n\t\n<\/div>\n<div id=\"frm_field_410_container\" class=\"frm_form_field form-field  frm_top_container frm6  frm_first\">\n\t<label for=\"field_eeujf\" id=\"field_eeujf_label\" class=\"frm_primary_label\">Alternative Date\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_eeujf\" name=\"item_meta[410]\" value=\"\"  data-sectionid=\"404\"  maxlength=\"10\" data-invmsg=\"Alternative Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_411_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n\t<div  id=\"field_xhbut_label\" class=\"frm_primary_label\">Alternative Time\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<select aria-labelledby=\"field_xhbut_label\" name=\"item_meta[411]\" id=\"field_xhbut\"  data-sectionid=\"404\"  data-invmsg=\"Alternative Time is invalid\" class=\"auto_width\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12:00 AM\" >12:00 AM<\/option><option value=\"12:30 AM\" >12:30 AM<\/option><option value=\"1:00 AM\" >1:00 AM<\/option><option value=\"1:30 AM\" >1:30 AM<\/option><option value=\"2:00 AM\" >2:00 AM<\/option><option value=\"2:30 AM\" >2:30 AM<\/option><option value=\"3:00 AM\" >3:00 AM<\/option><option value=\"3:30 AM\" >3:30 AM<\/option><option value=\"4:00 AM\" >4:00 AM<\/option><option value=\"4:30 AM\" >4:30 AM<\/option><option value=\"5:00 AM\" >5:00 AM<\/option><option value=\"5:30 AM\" >5:30 AM<\/option><option value=\"6:00 AM\" >6:00 AM<\/option><option value=\"6:30 AM\" >6:30 AM<\/option><option value=\"7:00 AM\" >7:00 AM<\/option><option value=\"7:30 AM\" >7:30 AM<\/option><option value=\"8:00 AM\" >8:00 AM<\/option><option value=\"8:30 AM\" >8:30 AM<\/option><option value=\"9:00 AM\" >9:00 AM<\/option><option value=\"9:30 AM\" >9:30 AM<\/option><option value=\"10:00 AM\" >10:00 AM<\/option><option value=\"10:30 AM\" >10:30 AM<\/option><option value=\"11:00 AM\" >11:00 AM<\/option><option value=\"11:30 AM\" >11:30 AM<\/option><option value=\"12:00 PM\" >12:00 PM<\/option><option value=\"12:30 PM\" >12:30 PM<\/option><option value=\"1:00 PM\" >1:00 PM<\/option><option value=\"1:30 PM\" >1:30 PM<\/option><option value=\"2:00 PM\" >2:00 PM<\/option><option value=\"2:30 PM\" >2:30 PM<\/option><option value=\"3:00 PM\" >3:00 PM<\/option><option value=\"3:30 PM\" >3:30 PM<\/option><option value=\"4:00 PM\" >4:00 PM<\/option><option value=\"4:30 PM\" >4:30 PM<\/option><option value=\"5:00 PM\" >5:00 PM<\/option><option value=\"5:30 PM\" >5:30 PM<\/option><option value=\"6:00 PM\" >6:00 PM<\/option><option value=\"6:30 PM\" >6:30 PM<\/option><option value=\"7:00 PM\" >7:00 PM<\/option><option value=\"7:30 PM\" >7:30 PM<\/option><option value=\"8:00 PM\" >8:00 PM<\/option><option value=\"8:30 PM\" >8:30 PM<\/option><option value=\"9:00 PM\" >9:00 PM<\/option><option value=\"9:30 PM\" >9:30 PM<\/option><option value=\"10:00 PM\" >10:00 PM<\/option><option value=\"10:30 PM\" >10:30 PM<\/option><option value=\"11:00 PM\" >11:00 PM<\/option><option value=\"11:30 PM\" >11:30 PM<\/option><\/select>\n\t\n\t\n<\/div>\n<\/div>\n<div id=\"frm_field_396_container\" class=\"frm_form_field frm_section_heading form-field \">\n<h3 class=\"frm_pos_top frm_section_spacing\">Additional Comments<\/h3>\n\n\n<div id=\"frm_field_397_container\" class=\"frm_form_field form-field  frm_top_container\">\n    <label for=\"field_e2j9v\" id=\"field_e2j9v_label\" class=\"frm_primary_label\">\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n    <\/label>\n    <textarea data-auto-grow=\"1\"  name=\"item_meta[397]\" id=\"field_e2j9v\" rows=\"3\"  data-sectionid=\"396\"  placeholder=\"Please provide any additional information that may assist us with your appointment request.\" data-invmsg=\"This field is invalid\" aria-invalid=\"false\"  ><\/textarea>\n    \n    \n<\/div>\n<div id=\"frm_field_412_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\n\t<div  id=\"field_ejinf_label\" class=\"frm_primary_label\">\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n\t<\/div>\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_ejinf_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_412-396-0\">\t\t\t<label  for=\"field_ejinf-0\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[412][]\" id=\"field_ejinf-0\" value=\"I understand this is a request for an appointment only and does not guarantee an appointment on my preferred date or time.\"  data-sectionid=\"396\"  data-reqmsg=\"This field cannot be blank.\" data-invmsg=\"This field is invalid\"   aria-required=\"true\"  \/> I understand this is a request for an appointment only and does not guarantee an appointment on my preferred date or time.<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_412-396-1\">\t\t\t<label  for=\"field_ejinf-1\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[412][]\" id=\"field_ejinf-1\" value=\"I understand Pickaway County Public Health will contact me to confirm availability and finalize scheduling.\"  data-sectionid=\"396\"  data-reqmsg=\"This field cannot be blank.\" data-invmsg=\"This field is invalid\"   \/> I understand Pickaway County Public Health will contact me to confirm availability and finalize scheduling.<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_412-396-2\">\t\t\t<label  for=\"field_ejinf-2\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[412][]\" id=\"field_ejinf-2\" value=\"I understand this form should not be used for urgent or emergency medical concerns.\"  data-sectionid=\"396\"  data-reqmsg=\"This field cannot be blank.\" data-invmsg=\"This field is invalid\"   \/> I understand this form should not be used for urgent or emergency medical concerns.<\/label><\/div>\n<\/div>\n\t\n\t\n<\/div>\n<\/div>\n<div id=\"frm_field_394_container\" class=\"frm_form_field form-field \">\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"  formnovalidate=\"formnovalidate\">Request Appointment<\/button>\r\n\r\n\r\n<\/div>\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_609_container\">\n\t\t\t<label for=\"field_fhsi5\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_fhsi5\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[609]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"k8oBu5wE6so8FeHsom8Cl+SqE\/f+X+7Xl1+QjulAztxtISTAwZlY7zS33iXXaujF\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4610d9f e-con e-atomic-element e-flexbox-base e-4610d9f-7b7ffbd \" data-id=\"4610d9f\" data-element_type=\"e-flexbox\" data-e-type=\"e-flexbox\" data-interaction-id=\"4610d9f\" data-e-type=\"e-flexbox\" data-id=\"4610d9f\">\n    \t\t\t\n<hr class=\"e-9267928-0cedac8 e-divider-base\" data-interaction-id=\"9267928\"  data-e-type=\"widget\" data-id=\"9267928\" \/>\n\t\t\t\t<div class=\"elementor-element elementor-element-69c602a elementor-widget elementor-widget-text-editor\" data-id=\"69c602a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Questions?<\/strong><br \/>Phone: (740) 477-9667<br \/>Pickaway County Public Health<br \/>110 Island Road, Circleville, Ohio<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\n<\/div>\n\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Request an Appointment Pickaway County Public Health Please Note:\u00a0Submitting this form is a request only and does not guarantee an appointment. 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