Beckley - Appointment Request

To request an appointment, please enter the information and press the '
Submit' button when you are through. A representative from our Central Appointment Desk will contact you to confirm your appointment. You must be an adult (18 years old or older) to request an appointment by E-mail over the Internet. If you are a minor (17 years old or younger), please call 800-677-5161, to make an appointment.

Due to the nature of electronic mail, please do not use this method of communication in an emergency situation. Should you believe that you have an emergency, please proceed to your nearest emergency facility.

If your need is not an emergency, please proceed.

When you press the "Send Appointment Request" button, you consent to correspond with Greenbrier Physicians Clinic staff by E-mail over the Internet.

You should use the Appointment Request Form below for non-urgent appointments only.

PLEASE NOTE THAT Greenbrier Physicians Clinic CANNOT GUARANTEE THAT THE INFORMATION YOU PROVIDE WILL BE CONFIDENTIAL WHEN SUBMITTED VIA E-MAIL OVER THE INTERNET. BY PRESSING THE 'SEND APPOINTMENT REQUEST' BUTTON, YOU AGREE TO RELEASE Greenbrier Physicians Clinic FROM ANY AND ALL LIABILITY ARISING OUT OF OR RELATED TO DISCLOSURES OF THE INFORMATION YOU PROVIDE VIA E-MAIL OVER THE INTERNET.

If you prefer to make an appointment by phone, or if you aren't sure of the appropriate department to make an appointment with, please call 800-677-5161.

First Name:*

Last Name: *

Phone:*

Reason for Appointment and/or Primary Complaint: Do not enter confidential information or comments in the space provided below. The information or comments you enter below will be shared with Greenbrier Physicians Clinic staff and/or placed in your medical record at your health care provider's discretion.

Department you would like to make an appointment with

Email Address:*

Submit

* Required