Request Appointment
Interested in an appointment with Independence Women's Clinic?
Please fill out the online appointment request form below and you will be contacted by our office. Completion of this online appointment request is not a confirmation of an appointment.
All existing patients are encouraged to contact the office via phone to communicate with the Practice.
All fields marked with
*
are required. Thank you.
If you or someone you care for is experiencing a medical emergency, please call 911
Personal Information
First Name
*
Last Name
*
Date of Birth
*
Phone
*
Are you a
*
New Patient
Current Patient
Appointment Request
Preferred appointment date
Preferred appointment time
Morning
Afternoon
Preferred Provider
Select Provider
Timothy A. Hall, MD
Robert T. Caffrey, MD
Michelle R. Lemberger, MD
Alisa R. Ash, MD
Kiersten Moreno, MD
Lyda Pung, DO
Amanda J. Sundling, DO
Debra K. Sims, WHNP-BC
Lindsay Hartley, WHNP-BC
Appointment type
Well woman
Prenatal
Problem
New OB
Message