DO NOT USE THIS PAGE FOR EMERGENCY MEDICAL CONDITIONS
Call (507) 625-1811,or our 24 Hour Health Line Service at (877) 222-7530 or 911

Request an Appointment Online

The following form is provided to enable you to request an appointment with a provider and department of your choosing.  You will receive a follow-up phone call from a scheduler within 48 hours of submission of this request.  Please call the clinic directly if you need a response more quickly. This form should not be used for specific health related questions; we cannot advise people about their medical conditions without an examination by one of our physicians.  Those questions should be directed to your Clinic physician by calling (507) 625-1811.

Please enter your name, e-mail address and your telephone number so we can contact you to confirm an appointment time. 

Please describe in the body of the e-mail what this appointment is pertaining to and select the department to direct this appointment request. 

 Appointment Schedule Form
Your Full Name: *
Date of Birth:(mm/dd/yyyy) / / *
Your Email Address: *
Your Area Code & Phone Number:
*
( *do not use dashes, spaces or parenthesis ex. 6128883333 )
Department: *
select the department to direct this appointment request.
Provider Name (Optional):
Please describe in the body of this field what this appointment is pertaining to: *