Request An Appointment

Please Note: If you are experiencing a medical emergency, call 9-1-1 immediately. This form is for appointment requests only. Please do not include medical symptoms or other personal or sensitive information in the fields below.

Southern Specialty Clinic provides specialty care for patients ages 18 and younger. Please use this form only to request an appointment for an eligible patient. After we receive your request, a member of our team will contact you using the information you provide to gather any additional details and assist with scheduling your appointment.