Primary Office
All fields are required
Type of Visit
New Patient Examination
Laser Therapy
Dry Needling
DOT Physical
Existing Patient Adjustment
Diagnostic Ultrasound
Video Visit
Office
Primary Office
Reason for Visit
e.g. Initial Consultation
Patient name
Firstname Lastname
Date of birth
mm/dd/yyyy
Email
email@example.com
Home phone
(555) 555-5555
Cell phone
(555) 555-5555
Requested time
Select a time below under Available Times
Office Address:
1210 Washington Street Highland IL 62249
1210 Washington Street Highland IL 62249
New and Existing patients can make appointments online.
Office Phone:
+1 618-654-4520
You must select a date and time for your appointment.
Available Times
Previous Week
Next Week
Visit Length:
15 minutes
Submit Appointment Request
You will receive an email confirmation.
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Action Required: Confirm your appointment