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About FCHC
Patient Resources
Services
Locations
Pharmacy
News & Media
- FCHC Photo Gallery
Careers
- Employee Spotlight / Grow with Us
Give
- Donate
- Giving Tuesday

Travel Medicine Appointment & Information Request Form

Name(Required)

First Last

Phone(Required)

Email(Required)

Date of Birth (DOB)(Required)

Destination(Required)

Date of Departure(Required)

Date of Return(Required)

Preferred Method of Contact:(Required)

Phone

Email

What do you need?(Required)

I’d like to schedule a travel medicine appointment

I’d like more information about your travel medicine services

I have questions about vaccines or medications for my trip

Other (please describe below)

(Select all that apply)

Please describe

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FCHC Corporate Office

5827 Corporate Way
West Palm Beach, FL 33407

Ph. (561) 844-9443
Fax (561) 844-1013

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FCHC is a private, non-profit, tax exempt 501(c)3, consumer directed corporation which is designated as a Federally Qualified Health Center (FQHC) and a Federal Tort Claims Act (FTCA) Deemed Facility. Florida Community Health Centers, Inc. is a FTCA deemed facility. This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n). This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals. For further information, please contact our Corporate office at 561-844-9443.

The Joint Commission National Quality Approval

NCQA Recognized

PCMH

FTCA Badge

Badge from Health Center Program awarded for National Quality Leader in Diabetes Health in 2025.

Badge from Health Center Program awarded to FCHC for ADVANCING HIT FOR QUALITY in 2025.

Badge from Health Center Program for being National Quality Leader in behavioral Health in 2025.

© 2026 Florida Community Health Centers, Inc.

About FCHC
Patient Resources
Services
Locations
Pharmacy
News & Media
- FCHC Photo Gallery
Careers
- Employee Spotlight / Grow with Us
Give
- Donate
- Giving Tuesday

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