MCGHealth is now accepting online appointment requests for all departments excluding dentistry. Please fill out the form below and click on the submit button at the bottom of the page to send. A representative from the Health Care Referral Center will then contact you with appointment options within 2 business days.

This online appointment request is secure (SSL technology) and information submitted will not be shared with persons outside the appointment-making process. 

To make an appointment for dentistry or to speak to someone in the HCRC directly, please call:
(706) 721-CARE (2273) between 8am-5pm EST, Monday-Friday.

Thank you for visiting MCGHealth.org.  

Designation  Mr.  Ms. Mrs.
Last Name:	First Name:
Birth Date	Age Years Months Days
Sex  Female   Male   N/A	Social Security Number

Street Address:
City:	State:	Zip Code:

Do you prefer to be contacted by:
Day Phone	Evening Phone	E-mail
Day Phone:	Evening Phone:	E-mail:
Primary Care Physician & Phone:

Insurance: Yes  No

Insurance Company Policy Number Group Number

Reason For Appointment:

Requested Physician

Clinic

Which days/times do you prefer for your appointment:
Monday Tuesday Wednesday Thursday Friday	8:30am - 10am    10am - 12pm   12pm - 2pm    2pm - 4pm Note: Times are independent of days.

Additional Comments: