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Request an Appointment

You can use this form to request an appointment or schedule a 2D ultrasound at Northline Women's Health Center. If you have a preference for a time of day or date for your appointment, please note this and allow one business day for a reply to confirm your request. If you are experiencing pain or symptoms, contact your doctor or 911 for immediate assistance. Please do not use this form to change and/or cancel your appointment or for medical questions.

Your Name	Please let us know your name.	OFFICE HOURS Northline Women’s Health Center-Southgate Monday - 8:00 a.m. to 7:30 p.m. Tuesday - 8:30 a.m. to 6:00 p.m. Wednesday - 7:00 a.m. to 6:00 p.m. Thursday - 8:00 a.m. to 7:00 p.m. Friday - 8:00 a.m. to 2:00 p.m. Northline Women’s Health Center-Brownstown Monday - 8:30 a.m. to 6:00 p.m. Tuesday - 8:00 a.m. to 5:00 p.m. Wednesday - 8:00 a.m. to 5:00 p.m. Thursday - 8:00 a.m. to 6:00 p.m. Friday - 8:00 a.m. to 2:00 p.m.
Your Email	Please let us know your email address.
Phone number	Please write a subject for your message.
Are You An Existing Patient?	YesNo Invalid Input
Office Location	SouthgateBrownstown Invalid Input
Preferred time	MorningsAfternoonsEvenings Invalid Input
Preferred date	Invalid Input
Message	Please let us know your message.

Northline Women's Health Center Locations:

15675 Northline Road

Southgate, MI 48195

(734) 282-3600
(734) 282-3603 - Fax

23050 West Road, Suite 210

Brownstown Twp., MI 48183

(734) 362-7000
(734) 362-7077 - Fax