Request an Appointment

Please note that an appointment is not confirmed until someone from Hope Clinic follows up with you to schedule a specific date and time for your visit.

If you need to contact Hope Clinic with a question, please call 541.672.2609 or submit the form below, and someone from our team will get back to you as soon as we can.

Name*
First Last
Phone*
Email*
Desired Services - Select all that apply*
- Pregnancy Test
- Ultrasound Exam
- Options Education
- Community Resource Referrals
- STI/STD Education
Preferred Date of Appointment (Monday through Thursday only)*
Preferred Time of Day*
- Morning
- Noon
- Afternoon
Is it okay to leave a voice message from Hope Clinic at the phone number you provided?*
- Yes
- No
Is this a cell phone or a home phone?*
- Cell Phone
- Home Phone
Name
This field is for validation purposes and should be left unchanged.

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Hope Clinic for Women offers pregnancy testing, ultrasound exams, and options education that are free of charge; however, we do not offer nor refer for abortion services or provide birth control.

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1425 W HARVARD AVE
ROSEBURG, OR 97471
541.672.2609
HOPECLINICROSEBURG.COM

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