Request an Appointment

Welcome to Story Medical Clinics online appointment request system. We are happy to make an appointment for you once we receive your request.

It’s important to note, online appointment requests are typically answered during the same business day, however it may take up to one full business day to respond to your request. If you need immediate assistance, please call the clinic of your choice during their business hours. If your request is an emergency, please call 911.

Patient Information

Has the Patient ever received services at any Story Medical Clinic?    
*First Name:  
  MI:  
*Last Name:  
*Birth Date:(ex 1/1/1980)    

Appointment Contact Information
Contact information is the same as above?:
*How would you like to be contacted for appointment confirmation?  
*First Name:  
  MI:  
*Last Name:  
*Address:  
*City:  
*State:
*Zip:    
*Phone:  
*Email:    

Appointment Request
*Clinic Preference:  
*Primary Care Provider:
*Reason for Appointment  

Appointment Time Preferences

Please select your available days and times below.
Additional Comments:
If you have problems with the online appointment request system, please contact our webmaster at info@storymedical.org. Thank you!