Complete the form below:

Do NOT use for Emergencies (Instead: Dial 911 or call us at 774-8200).

Note: Red Input Boxes or Shaded in

BLUE are Necessary.

First Name:

Mid:

Last Name:

DOB: Month Day Year

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Your Email Address:

Your Phone 1:

Your Phone 2:

Send EMail Confirmation? Yes:   No:

Request Lab Report:

Request Statement:

Your Message:

Office Hours: Monday thru Friday 8:30AM to 5:00PM

Office Address:
Mark O’Brien MD
4070 Lake Dr. # 201
Grand Rapids, MI 49546
 

Phone: 616 - 774 - 8200 
Monday thru Friday 8:30AM to 5:00PM 
Note: We close for lunch from 12:00 to 1:30PM.
In the Summer, we sometimes close early on Wednesdays.

Fax: 616 - 774 - 0304  Our Fax machine is always ON.

Click Here for Prescription Refills or Appointment Requests