APPOINTMENT REQUEST
 

Thank you for choosing the following Maury Regional Medical Group (MRMG) practice. Patients may request an appointment using the form below. Once your contact information is received, a member of our team will contact you within one business day to schedule your appointment.

MRMG Primary Care Collinwood
902 Highway 13 South
Collinwood, TN 38450
931.722.9999

Monday, Wednesday and Friday: 8 AM-Noon

Tuesday and Thursday: 1 PM-4 PM
I would like to schedule an appointment with:  *
First Name:  *
Middle Name:  *
Last Name:  *
Street Address:  *
City:  *
State:  *
Email:  *
Phone:  *
Is this a cell or home phone?:  *
Preferred Method of Communication:
(Initial contact will be a phone call to the number provided above. Your appointment confirmation may be sent to the preferred method you select below.)  *
First visit to this practice?  *
Preferred Day(s): 


Preferred time(s): 
Appointments may be offered in our office or via telehealth, depending upon availability. Please indicate your preference. 
Appointments may be offered in our office or via telehealth, depending upon availability. Please indicate your preference.