PLEASE DO NOT USE THIS FORM FOR MEDICAL ADVICE OR IMMEDIATE ATTENTION.
This form is not HIPAA compliant and your personal health information is not protected through this inquiry.
We make every effort to respond to these requests in a timely manner, but we do not guarantee same day response with this form. If you are in need of immediate attention, please call our office at (563) 355-1853. If you are calling or contacting us after normal business hours, our answering service will send all calls promptly to the provider on call and we will return your call as quickly as possible. If you are experiencing a medical emergency, please dial 911.