If you would like to request an appointment at our hospital, please fill out and submit the form below, or contact us at (336) 286-9500 . Please note that this is only a request, someone from our office will contact you shortly to confirm a date and time for your appointment. If your matter is URGENT, or you feel you are experiencing an EMERGENCY, please call us immediately at (336) 286-9500 and DO NOT use the form below.