Skip to Content

Online Appointment Request

* Denotes required fields
* Are you a new patient?
If patient is a minor please include the parent/guardian's name who should be contacted.
I authorize Rush-Copley Medical Group to leave me a message regarding scheduling my appointment at this preferred method of contact.

Appointment Preferences

* Best Time to Contact You

Insurance & Billing

Would you like to receive email notifications of Rush-Copley news and events?

Find a Location

  • Appointment Request- Primary Care