Request an Appointment

with Baptist Primary Care

Request an Appointment

To request an appointment, complete the following form. We will contact you within 2 business days to confirm your request. By submitting your request via this web page, you are authorizing us to confirm the appointment using the e-mail address you provide below.

Please Note: This service is only for NON-emergency appointments. If you have a medical emergency, please call 911.


Patient Information

Are you a new patient? (required)*

Date of Birth (required)*

Select your birth month from the dropdown, then enter your birth day, followed by your birth year.
E.g. January 01, 1990
Your Physician Preferences
Gender at birth
Additional Information