MDH Medical Group - Request an Appointment (new patients only)

McDonough District Hospital offers a multispecialty group of physicians and advanced practice providers determined to serve as many of your health care needs as possible.

Our clinicians and office staff are committed to helping you live well and feel your best.

If you are a NEW patient needing to schedule an appointment with a primary care or specialty provider, fill out the contact information form below. A member of the MDH Medical Group staff will contact you during the preferred time you indicate in order to schedule you an appointment.

Please fill out the form and click submit. If you wish to contact the MDH Physician Referral Service directly, call (309) 833-MYMD (833-6963).

Personal Information

* Indicates Required Field
First Name*

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Last Name*

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Date of Birth

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Email Address*

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Phone Number*

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What is the preferred method to contact you*

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What is the best time to call you*

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If a Primary Care appointment, what is the preferred location for your visit*

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Work/Auto Related Injury*

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Reason for your visit*

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Preferred Provider to see*

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