Request an appointment

Send your availability securely. Staff will review the request and contact you to schedule or discuss the waitlist. Submitting this form does not confirm an appointment.

What would you like the office to do?

Request an appointmentStaff will contact you to arrange an available time.Join the cancellation waitlistStaff will review your availability for an earlier opening or cancellation.

First nameLast nameMobile phoneEmail (optional)

I am aType of careEarliest date (optional)Latest date (optional)Preferred time

Preferred days (optional)

MondayWednesdayThursday

Security check

Enter the six-character visual code, or use the spoken-code option. Letters are not case-sensitive.

Security code

Cannot use either format? Call 864-246-5554. Staff can take the request without requiring this challenge.

I authorize the office to contact me about this request. I understand this does not reserve or confirm an appointment or automatically add me to the waitlist.

Do not enter symptoms, diagnoses, insurance details, Social Security numbers, or urgent medical information.