Request an Appointment - Patti's Place: Vital Pediatrics for Complex Kids, LLC | Dr. Patricia Shearer
Patti's Place: Vital Pediatrics for Complex Kids, LLC | Dr. Patricia Shearer logo for print

Phone: 404-986-8756 | Fax: 404-986-0803

Request an Appointment

Please complete and submit the appointment request form below. Our office staff will contact you to confirm your appointment.

Dr. Patti offers secure virtual visits from your computer or mobile device.

Patient Information
Patient Name:
Patient Date of Birth:
New or Existing Patient? New Patient
Existing Patient
Home Phone:
Cell Phone:
Email Address:
Preferred Contact Method: Home Phone
Cell Phone
Email
Insurance:
Appointment Information
Preferred Day: Monday
Tuesday
Wednesday
Thursday
Preferred Time: Morning (AM)
Afternoon (PM)
Secondary Preferred Day: Monday
Tuesday
Wednesday
Thursday
Secondary Preferred Time: Morning (AM)
Afternoon (PM)
Question/Comment: