Request an Appointment

You may use this form to schedule an appointment with the family medical providers at Mount Ayr Medical Clinic. You can also use this form to schedule an appointment at one of our outpatient specialty clinics (just choose the appropriate category under "Services" in the interactive form below).

Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment. Instead, contact our office at (641) 464-3226. After you submit your request, our appointment scheduler will respond within 48 hours.

You can also download new patient forms to save time at your appointment at Mount Ayr Medical Clinic. Established patients may log in to the patient portal to request appointments and update forms.