Contact Us

Fill out the form below and someone from our team will reach out to find a time that works best with your schedule.
APPOINTMENT REQUESTEMAIL US

MEDICAL/DENTAL REFERRAL FORM

Fort Wayne Office

1120 East Dupont Road
Fort Wayne, IN 46825

Call/Text: (260) 497-0497
Fax: (260) 489-4853

Monday – Thursday: 8AM – 5PM
Friday: 8AM – 4PM

Warsaw Office

841 South Union Street
Warsaw, IN 46580

Call/Text: (574) 267-1490
Fax: (574) 267-1405

Monday: 8AM – 5PM
Tuesday: 8AM – 4PM
Thursday: 8AM – 4PM

Appointment request

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly.

Fort Wayne office: (260) 497-0497
Warsaw office: (574) 267-1490

Name(Required)
Are you a new or current patient?(Required)
Please let us know the preferred date and time for your appointment. While we can't make any guarantees, we will try our best to get you scheduled at a time that works for you!