Skip to main content
Request Appointment
Appointments
Leave us a Review
Review
Referral Form
Referrals
Patient Portal
Pay My Bill
Toggle navigation
Providers
Eye Care Doctors
ENT Care Doctors
Audiologists
Patient Info
Patient Resources
Make an Appointment
Patient Portal
Patient Forms
Your First Visit
Insurance Information
Policies
Notice of Privacy Practices
Patient Survey
Services
All Services
Eye Services
Ophthalmology
Optometry
Optical
ENT Services
Otorhinolaryngology (ENT)
Audiology
Allergies
Eye & Face Aesthetic Center
Monoclonal Antibody Treatment
News
& Articles
All News & Articles
Doctor Articles
News & Events
Eye News
ENT News
About
Us
About Premier Medical Group
Premier's Specialties
Employment
Locations
Contact Premier Medical Group
West Office Location
East Office Location
Providence Location
Daphne Location
Foley Location
Satellite Locations
Appointments Captcha
Appointments Captcha
Use the following form to request an appointment.
Patient Name*
Patient Address
Patient Birthdate*
Patient Email*
Patient Phone Number*
Your name if different from the patient name
Alternate Phone Number
Insurance Provider
What type of service do you need?
Eyes
Ear, Nose and Throat
Select an office location:
West Office (3701 Dauphin)
East Office (2880 Dauphin)
Providence Office
Daphne Office
Fairhope Office
Jackson Office
Select a doctor (optional):
--Select a Doctor--
Dr. Curtis Graf
Dr. James Harrison
Dr. Charles Mosteller
Dr. Matthew Mosteller
Dr. Charles Salisbury
Dr. Andrew Terry
Dr. Chris Walton
Dr. Claude Warren
Dr. Kimberly Elliott
Dr. Mark Harrison
Dr. Alfred M. Neumann, Jr.
Dr. James Pitcock
Dr. James Spires
Dr. Stuart Ball
Dr. Jay A. Brown
Dr. Mark J. Douglas
Dr. Richard Duffey
Dr. Gregory Jackson
Dr. Ben King
Dr. H. Christopher Semple
Dr. Rollins Tindell
Dr. Valerie Vick
Dr. W. Carter Bryars
Dr. Michael Lee
Dr. Andrea McMurphy
Dr. Richard Palesano
Dr. Ron Swain, Jr.
Dr. John Wilson
Dr. Charles Jones
Dr. Jeffery Morrow
Dr. Van Crocker
Dr. Kimberly Elliott
Dr. Mark Harrison
Dr. Ron Swain, Jr.
Dr. J. Ryan Turner
Dr. Melissa Hoercher
Dr. Alfred M. Neumann, Jr.
Dr. Robert Edge
Dr. J. Ryan Turner
Dr. Melissa Hoercher
Dr. Jay A. Brown
Dr. Mark J. Douglas
Dr. H. Christopher Semple
Dr. Valerie Vick
Dr. Rollins Tindell
Dr. Alfred M. Neumann, Jr.
Dr. Van Crocker
Please briefly describe your symptoms
Were you referred to us by another physician?
Yes
No
Referring Physician
Referring Physician Phone Number