Appointment Request

Appointment Request Form:

If you would like to request an appointment, please call us at 505-243-1313. We will try to answer any and all of your questions that this site could not answer. Our policy is to try to see a patient who has a real problem as soon as possible so we will try to schedule an apointment for you as soon as we have an opening. That can likely be the same day. However, please allow enough time for a new patient examination. Dr. Cecil is very thorough and will spend some time with you.

Name:

Doctor's Name (Leave Blank If Unknown):

Date:

Time:

E-mail:

Phone:

Health History Form:

The fastest way to make an appointment is to call our office at 243-1313. If you would like you can fill out new patient information before you come in. In order to allow us to prepare for your first visit, you can fill out your Health History form on or offline in advance. This will provide us with the necessary information to better serve your health care needs.

(Please note: You may print out each page of the "Health History Securely Online" directly to your printer, fill it out by hand and bring it with you to your first visit if you prefer.)

You may:

Submit Your Health History Securely Online

or use the link below to print the

Print the PDF of the Health History Form,
complete it and bring it to your appointment.

Get instructions on downloading Adobe Acrobat Reader to view PDFs