Request an Appointment
Smith Chiropractic Clinic
7981 Dexter Rd Suite 101
Cordova, TN 38016
901-794-0876
info@smithchiropracticcordova.com
*Indicates a Required Field

Please view our office hours and then fill in the following form to request an appointment. You will receive a confirmation call to verify, before any appointment is scheduled.

*First Name
*Last Name
*Phone
 format: XXX-XXX-XXXX
*Email Address


Date and Hour for Requested Appointment

*Select Hour *AM/PM

*Please tell us if you are a current patient, or are requesting to become a new patient.
I am a current patient at your office
I am looking to make an appointment to become a new patient


Optional Short Comments or Message

For verification purposes, please type in the numbers and letters that you see below then press the Send Request button.

NOTE: You do not have a scheduled appointment until we can call you and verify this appointment request.

               

Monday
9:00 - 12:00 and 3:00 - 6:00
 
 Wednesday
9:00 - 12:00 and 3:00 - 6:00
 
Thursday

9:00 - 12:00 and 3:00 - 6:00

 

Please call to schedule your appointment. We have designated times
each week when we schedule our new patients. These slots fill up fast,
so if you are interested, call today.