Please fill out the form below for an appointment. We will call you as soon as possible to schedule your appointment. Our clinic office is closed Saturday and Sunday. Please expect a response during office hours Monday through Friday. If you do not receive a response during office hours within 24 hours please call: 801-387-4750.

This appointment request form should not be used for urgent or emergency care. If you are experiencing life threatening symptoms dial 911 or go to the nearest emergency room.

This form should not be used for urgent care matters or potentially life threatening conditions. In those situations, please contact 911 or head to the nearest Instacare or emergency room.

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Please use the format (MM/DD/YYYY)
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