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. Response time will be delayed when offices are closed due to inclement weather.

MRMG Primary Care & Pediatrics
1222 Trotwood Avenue, Suite 108
Columbia, TN 38401
931.380.4066

Monday, Tuesday, Wednesday & Friday
7:30 AM - 4:30 PM

Thursday
7:30 AM - 5 PM
I would like to schedule an appointment with:  *
First Name:  *
Middle Name:  *
Last Name:  *
Street Address:  *
City:  *
State:  *
Zip Code:  *
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. 
Terms of Submission: Maury Regional Health may use your contact information to reach you in response to your inquiry or to share additional information that may be of interest. You also acknowledge that despite potential use of encryption software, security of this submission is not guaranteed. By selecting SUBMIT, you agree to these terms.