Callback RequestPlease enable JavaScript in your browser to complete this form.Name *FirstLastPrimary Phone Number *Please ensure this phone number is working and has a voicemail box set up and not full. Reason for Callback *Request an AppointmentCancel an AppointmentRefill Medication(s)Test Result(s)General Medical QuestionOtherPlease allow Cross Valley Health & Medicine up to (2) business day to contact you. In the event of higher call volumes, a notification will appear on this webpage. When can we call you? *Morning [AM]Afternoon [PM]Evening [PM]No preferencePlease tell us more!NOTICE TO PATIENTS: Cross Valley Health & Medicine takes great pride in protecting and respecting the privacy of its patients. E-mail communications are not normally considered to be private or secure. Patients have the option of using our more secure methods of communication such as phone (845-561-7075), or fax (845-561-7006) or messages sent through our OneTouch EMR Patient Portal. Upon submitting this Contact Form, Cross Valley Health & Medicine assumes you understand the potential risks of using email and are comfortable with said risks. Patients are strongly cautioned against sending highly sensitive, detailed personal information to Cross Valley Health & Medicine via e-mail. If you need further help or have any questions, please call 845-561-7075.Submit
