To request an appointment for a performing arts-related problem, please complete the form below. If you have other questions about the program, please call (608) 265-0062.
Please do not submit urgent questions about your medical care through this website. If you are experiencing a life- or limb-threatening emergency, call 911. If your need is urgent, call your clinic for assistance.
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Phone Number (including area code)*
Reason for Request*
If this is an emergency, please visit the Emergency Department immediately.
Ear, Nose or Throat Injury
Allergy or Pulmonary Problem or Injury
Anxiety or Mental Health Issue
Musculoskeletal Problem or Injury
Neurological or Movement Disorder
Integrative Health Issue
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