Appointment Request

Please use this form to request an appointment. While we will do our best to accommodate your requested day and time, your appointment is not fully booked until you get a confirmation call or text from us.

PLEASE NOTE: This form is for appointment requests only - all other questions or inquiries will not be answered. For records/prescriptions requests or any questions regarding your bill or insurance, please give the office a call at 334-699-5999 and someone will be glad to help you.

Appointment Request Form

Submit the following information to request an appointment

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