Request an appointment

Please fill out his form to request a clinic appointment. All fields are required in order to process your request. Someone will respond to your request between 8:00 am and 5:00 pm. Monday through Friday. If you are seeking an appointment within the next 48 hours, please call us at 320-769-4323.

Request An Appointment
  1. (required)
  2. (required)
  3. (required)
  4. (valid email required)
  5. Preferred Method of Contact

  6. Preferred Location

  7. Preferred Provider

  8. (required)
  9. Preferred day of the week:

  10. Preferred Time


cforms contact form by delicious:days

%d bloggers like this: