Request An Appointment

Fill out the information below

After submitting this form, a Foothills representative will contact you shortly to secure your appointment. If you need immediate scheduling assistance, please call your desired clinic directly.

  • Date Format: MM slash DD slash YYYY
  • *Must provide 24 hour notice to cancel a scheduled appointment without penalty.

    Please note: We attempt to accommodate all appointment requests, but appointments are not confirmed until you receive a call from our front office.