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 Frederick 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.

Your Name*
First Last
Your Phone*
Alternate Phone (Optional)
First, Choose a Specialty*
Do You Have a Provider Preference?
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.
Choose a Location*
Locations Are Limited by Specialist Availability