Request An Appointment

To schedule at any of our 17 locations fill out the form below and we will contact you within 24 hours or the next business day.

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.

Full Name

Phone Number

Email Address

Location

Doctor

Reason to be seen

Intermountain is required by law to inform you that there is some risk that emails may not be secure once it leaves the Intermountain Healthcare system. By submitting an email you consent that these communications may be sent to you, despite being informed of this risk.