Request an Appointment or Virtual Visit

We want to help you in requesting an appointment or virtual visit with our providers at USA Health. Use the form below to fill in your personal information, medical need, health insurance and preferred doctor, if applicable.

Existing patients who have registered for the MyUSAHealth patient portal can use the portal to view or cancel previously scheduled appointments.

Please note that you should receive a reply within one business day. If you have an urgent need, please call the location where you receive care. If this is an emergency, please call 911.

Patient Information

Patient StatusI am a

New Patient

Returning Patient

First Name

Last Name

Contact Phone Number

Date of Birth

Gender

Insurance

Other Insurance

Appointment Information

Specialty

Service

Preferred Day of the Week

Preferred Time of Day

Message

Preferred Provider

For questions or to request an appointment by phone, please call (251) 434-3711.

Find a Provider

Physicians Group

Find a Service

Specialties

Clinical Trials

Facilities

Physicians Group Clinics

Patients

Visitors

I'm a Patient

I'm a Visitor

I'm a Doctor

I'm a Job Seeker