Online Appointment Request

If you are an established patient with Cary Medical Group and would like to schedule a future appointment, please provide the following information. Your appointment will be confirmed by email within 48 hours. In the event we are unable to accommodate your request, you will be contacted at the phone number provided.

Personal Information:

First Name:

Middle Name:

Last Name:

Phone Number (with area code) :

Your email:

Date of Birth:

Appointment Information:

Your Primary Cary Medical Group Physician:

Preferred Month:

Preferred Day(s) of the Week:

Preferred Time of Day:

Reason for Appointment:

I understand that completion of this form is only a request and that if my request is accepted, I will receive an email confirmation of my appointment within 48 hours. I also understand that if I do not receive a reply, I can call Cary Medical Group Scheduling Department at 919.859.5955 and request an appointment.