Appointment Request Form Please note doctor’s schedule: The doctor examines patients on Wednesdays and Fridays. The office is open 6 days a week but Dr. Cross gives patient care on Wednesdays and Fridays only. Please fill in the form below to setup an appointment.Reason for AppointmentPlease provide a reason for your appointment. Details are stored securely and not sent by email.Preferred Date & Times*Please let us know when you would prefer to have your appointment. Our hours are listed on our location page. The office is open 6 days a week but Dr. Cross gives patient care on Wednesdays and Fridays only.Patient Type*New patientReturning patientPlease let us know if you are a new or existing patient.Name* First Last Phone*Email* Best Time to be Reached for Confirmation* : HH MM AM PM CommentsEmailThis field is for validation purposes and should be left unchanged.