Please submit the form. We will contact you to set up your appointment. Contact Appointments Name * Email * Phone Date Of Birth Sex Select OneMaleFemaleOther Doctor Select OneDr. Robert AyerDr. Bethwel RaoreDr. Mairaj SamiDr. Dave SeecharanPhysician Assistant Reason (optional) Select OneFollow UpPost ProcedurePro-OPImaging ReviewOther (please include details in comments)Consulation (please include details in comments) Office Location Select OneSuwaneeBethlehemColumbus Comments I have read and agreed to the Privacy Policy and Terms of Use, and I am at least 13 and have the authority to make this appointment. I agree I agree to receive text messages from this practice, and understand that message frequency and data rates may apply. I agree Submit If you are human, leave this field blank.
I have read and agreed to the Privacy Policy and Terms of Use, and I am at least 13 and have the authority to make this appointment.
I agree to receive text messages from this practice, and understand that message frequency and data rates may apply.
