Request an Appointment

Fill out the form below to request an appointment at one of our locations.

Welcome to Highlands Oncology

If you are a new patient, we understand this can be overwhelming. We are here to walk you through the process of getting an appointment and connecting with a new patient navigator. Please complete the form and a member from our New Patient Intake dept will contact you.

If you are a returning patient, please enter a detailed message and your message will be returned by a member of our triage team. Please note this general mailbox is NOT monitored after hours or on the weekend. If you have an urgent need occurring after hours, please call the office and the on-call provider will be paged.

Request an Appointment

Name(Required)

First Last

Email(Required)

Phone(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth(Required)

Sex

Choose your clinic location(Required)

Choose your appointment type(Required)

Who is your doctor?(Required)

What is the reason for your referral?(Required)

Any additional information?

CAPTCHA