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972-682-8917

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Fill out the form below to request an appointment within the next week. For same day appointments, please call us at (972) 682-8917

Company

First Name / Nombre *

Last Name / Apellido *

Phone Number / Número de teléfono *

Email Address / Dirección de correo electrónico *

If you are needing to reschedule your appointment or needing to schedule a same-day appointment, please call 972-682-8917

/ Si necesita reprogramar su cita o necesita programar una cita para el mismo día, llame al 972-682-8917

Type of Patient / Tipo de paciente

New Patient / Paciente nuevo

Existing Patient / Paciente existente

I would like to request an appointment for / Me gustaría solicitar una cita para: *

Medical Clinic / Clinica Medica

Dental Clinic / Clínica dental

Counseling, Behavioral Health (appointments available for medical patients) / Asesoramiento, salud conductual (citas disponibles para pacientes médicos)

I'm not looking for an appointment but need to talk to someone about another situation.

Preferred Location *

Mesquite Office

Sachse Office

Sunnyvale Office

Agape Clinic

Not Sure/Flexible on Location

Preferred Days of Week or Times of Day For Appointment / Días preferidos de la semana u horas del día para la cita:

Questions or Comments / Preguntas o comentarios::

We're Here For You

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Email

[email protected]

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Phone

(972) 682-8917

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Locations:

MED Mesquite

MED Sachse

Agape Clinic

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If you are experiencing an emergency, please dial 9-1-1 immediately. If you are a Mission East Dallas (MED) patient and need to reach us after hours for a non-emergency medical or dental problem, please call 972.682.8917 and an after-hours nurse triage service can assist you with your concerns.