Appointment Request Form

  • If you’d like to request an appointment with one of our physicians, please fill out the information below.
  • Our schedulers are available from 6 a.m. to 6 p.m. five days a week Monday through Friday.
  • To schedule an appointment for Fort Collins, Loveland or Greeley locations please call: 970-419-7050
  • To schedule an appointment for Longmont, Lafayette, or Westminster locations please call: 303-772-1600
  • Or fill out the information below.
  • Please review the phone number(s) you entered before you hit Submit.
  • One of our schedulers will call you back to get additional details.
  • If you would like to see a specific provider, you may select them here. If you have no preference or looking for the next available you can skip this question.
  • Locations Are Limited by Specialist Availability