COEM is a fee for service medical center. Please click here to further understand our financial policy.

REQUEST FOR NEW PATIENT INFORMATION

First Name

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Last Name

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Your e-mail address

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Your telephone number

Please enter country code and area code along with #

City

State

Country

Illness/Health Issue for which you are seeking help

Security Question: 4 + 9 = Required

Once you submit your Request for New Patient Information, our New Patient Coordinator should be contacting you by phone or e-mail within 48 hours.

Calls and e-mails are returned on normal business days, Monday through Friday between the hours of 9-12 and 1:15-5 pm.

Potential New Patients are contacting us from all over the world and we do our best to respond in a timely manner but if for some reason you do not hear from us in a short time, please feel free to call The Center at (843) 572-1600.