Name:
E-mail:
Preferred phone #:
First Preference Date Time: a.m. p.m.
Second Preference Date Time: a.m. p.m.
Our select after office-hours option weekday evening sunrise Tuesday early Saturday morning
Please estimate how much time you will need to address your problem. This gives us an idea of how much time to block for you in the clinic schedule.
Your best guess: 15 minutes half-hour 45 minutes hour +
Also, please click all the reasons for which you want to be seen:
emergency room follow-up
second opinion
nerve testing (EMG/NCS)
disability exam
independent medical exam
self scheduled
emergency/new problem
injection
ultrasound exam
discuss testing results
osteoporosis / arthritis
referred
Please share with us any other comments that you think we should know:
Our office staff checks scheduling requests first thing in the morning and in mid afternoon and will contact you as soon as your request is processed.
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