Request an Appointment

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Please note that Magnolia Express Care provides convenient, in-person care for minor illnesses and injuries. Express Care is walk-in only, and appointment requests are not used for this clinic. If you have questions, feel free to call us at (662) 286-1499.

To help us serve all patients efficiently, we kindly ask that you avoid calling multiple times, as this can delay our team’s ability to return calls and assist others.

If you are experiencing emergency-like symptoms, please do not use this form. Instead, visit your nearest emergency room or call 911.

Patient Information

Your Name(Required)

First Middle Initial Last

Your Address

Street Address Address Line 2 City ZIP Code

Date of Birth(Required)

Daytime Phone(Required)

Mobile Phone

Best time to contact you

Appointment Information

Are you a new or existing patient?(Required)

Is this appointment for Our Express Care Clinic?(Required)

Yes

Which clinic are you wanting to schedule an appointment with?

Other Information

Your Comments/Questions(Required)