Cancellation Request – Family Medical Walk-In Clinic

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Most Patients are in and out in under an 1 hour.

We are sorry to see you go. Please fill out the form below to cancel your membership or remove members.
What would you like to do?
- Cancel Membership
- Remove members from plan
Estimated Cancellation Date
00/00/0000
Account Information
First Name*
Last Name*
Date of Birth*
MM slash DD slash YYYY
Primary Phone*
Secondary Phone
Email*
Members*
First Name * Last Name * Date of Birth *
Reason for Cancellation*
Please provide other reason
Cancel Date*

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Family Medical Walk-In Clinics, Inc. is an urgent care medical facility; we were founded in 1997 and have REMAINED independently owned and operated since we first opened our doors

Useful Links

Springfield
4049 S Campbell Ave.
Springfield, MO 65807
417-890-5550

Republic
281 US Highway 60 West
Republic, MO 65738
417-851-4046

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Family Medical Walk-In Clinic – Springfield

Current walk-in wait time is min.

4049 S Campbell Ave.
Springfield, MO 65807
417-890-5550

Family Medical Walk-In Clinic – Republic

Current walk-in wait time is min.

281 US Highway 60 West
Republic, MO 65738
417-851-4046

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First Name *	Last Name *	Date of Birth *