Request an Appointment with Dakota Medical

To request an appointment, please fill out our online form.

Once we hear from you, we will reach out to schedule your visit with the appropriate medical providers. If you’d like to contact us for any other reason, you can call our office at 701.852.6143 or use our online contact form.

Appointment Request Form

Name

First Name

Last Name

Email

Phone

(###)

###

####

Which medical services are you interested in?

Select all that apply.

General Surgery

Hand Surgery

Ophthalmology

Orthopedics

Podiatry

Other

Please describe your reason for contacting Dakota Medical:

How did you hear about us?

Is there anything else you would like our team to know?

Request An Appointment

To request an appointment, please fill out our online form.

Appointment Request Form