Request an Appointment

We will do our best to find the right time for your healthcare appointments.  Please note that:

You can use this E-Request process to make advance scheduled appointments to fit your schedule, for routine follow-ups, and for a Health Maintenance / Preventive visits.

Same day appointments are available every day.  Please call as early in the day as possible, and we will do our best to work you in.

Health Maintenance visits focus on preventive care and are scheduled for longer (30 – 50 min) time periods. Please consult our Schedule of Preventive Health Care Visits.

Visits for acute (sick) care, or follow-up of chronic medical problems are scheduled based upon the number and complexity of the issues to be addressed.  Please let us know your MAIN reason for the visit, as well as ALL other expected needs, so that we can schedule appropriately. We may ask that you schedule more than one visit.

Practitioner Schedules
(Subject to some changes, but in general this is what we follow).

 
Mon
Tues
Wed
Thurs
Fri
Molly Backup PA-C
8 - 4:30
8 - 5
8 - 4:30
8 - 4:30
Jim Dougherty MD
9 - 5
8 - 5
8 - 5
8 - 5
Jan Ferris DO
9 - 4
9 - 5
 
9 - 5
Micheal Johnson MD
9 - 5
 
1 - 5
1 - 5
9 - 5
Paul Reiss MD
9 - 5
8:30 - 4:30
9 - 5
8:30 - 4:30
Nancy Resi FNP
8 - 5
8 - 4
8 - 5
8 - 5

Please fill out each segment of this form

Fields marked ( * )

 

 

Name:

First: *

Last: *

Please Check One: Current Patient:
  New Patient:

Date of Birth:

*

Month: *

Year: *

 

 

Email: *

 

Home: *

 

 

Phone:

Work:

 

 

 

Cell:

 

 

 

 

Address:

Street:
City: State: Zip:

 

Reason For Appointment:

 

 

Preferred Date of Appointment:

Choice 1: Day: * Month: * Time of Day: *

Choice 2:

Day: * Month: * Time of Day: *

 

 

Preferred Practitioner: *

 

Type of insurance:*
Policy holders name:* ( if different from patient )

Comments:

 

PLEASE NOTE: THIS REQUEST USES ROUTINE INTERNET MAIL.  WE DO NOT GUARANTEE THAT THIS COMMUNICATION WILL BE SECURE AND PRIVATE.  If you wish to ensure privacy, contact us by phone or fax instead.

 

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