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If you are currently having thoughts of harming yourself or others, please immediately dial 911 or the National Suicide Lifeline at 800-273-8255 or go to the nearest emergency room.

If you wish to expedite the insurance verification process for a sooner appointment, please provide your information below. Your insurance benefits must be confirmed before an appointment is scheduled. If you are self-pay, please put "N/A" in the insurance related text boxes to the submit form.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Is it ok to leave a detailed message? *

Date of Birth? Dr. Muir treats patients 18 years old and up. *

Insurance or Self-Pay? *

Insurance Patient ID# and Group# *

Please list the "Provider Services" or "Claims" number on back of your card *

Brief Reason for the Appointment *

When Did your symptoms start? *

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Request An Appointment

Let's Get Started!