GRHealth accepts online appointment request.

Many specialists require a physician's referral before they accept an appointment. 

Please know that you may need to obtain this referral before we can schedule an appointment.

Please fill out the form below and click on the submit button at the bottom of the page to send. A representative will then contact you with appointment options within two business days.

Please note: This form is not intended for urgent appointments or for appointments that you may need within three business days.
If this is a medical emergency, immediately call 911 or go to the nearest emergency room.

  • Urgent Appointments: If you wish to request an appointment within the next three days, call 706-721-CARE (2273) or 800-736-CARE (2273).
  • Dental Appointments: To request an appointment for dentistry, please call 706-721-2371 between 8 a.m. - 5 p.m. EST, Monday-Friday.
  • Privacy and Security: This online appointment request is secure (SSL technology) and information submitted will not be shared with persons outside the appointment-making process.

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Receive appointment reminders convienently through text messages on your cell phone.
TEXT "GRHEALTH" to 622622

Please ensure that we have the most accurate cell phone number on file.
Message and data rates may apply depending on your service provider and plan.

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* Required
Last Name: * First Name: *
Birth Date * Age *
Social Security Number (Last Four Digits Only)

Street Address:
City: State: Zip Code:

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

Insurance Company Policy Number Group Number

Reason For Appointment:
Requested Physician Clinic

Which days/times do you prefer for your appointment:

Note: Times are independent of days.

Additional Comments:

Your information will take a moment to process. To avoid duplicate submission, please do not click on the back button or hit submit more than once.