Request an Appointment

Please fill out the details in the form below to submit a new appointment request for Suburban Hematology Oncology. If you are a NEW patient to our practice, you can also email the new patient coordinators at each location:

Buford: NPbuford@shoaonc.com

Duluth: NPduluth@shoaonc.com

Hamilton Mill: NPhmill@shoaonc.com

Lawrenceville: NPlaw@shoaonc.com

Snellville: NPsnellville@shoaonc.com

Please include your name, DOB, address, phone number, referring provider, reason for visit, and insurance information.

For existing patients, please fill out the form below.

DISCLAIMER: If you are experiencing a medical emergency, please call 911. This form is for appointment requests only.

To request paper copies of medical records, please fax 678.771.6143

Our billing department fax number is 678.780.4969

Appointment Request Form

First Name

Last Name

Message

Date of Birth required

Race

Gender

Street Address

City

Postal / Zip code

Region/State/Province

Phone

Preferred Language

Patient Status Required

Existing Patient

New Patient

Insurance Company

Policy ID Number

Referring Physician and Diagnosis

I agree to recieve phone calls and text messages at the above number.

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By opting into SMS from a web form or other medium, you are agreeing to receive SMS messages from NSH Cancer Institute. This includes SMS messages for appointment scheduling, appointment reminders, post-visit instructions, lab notifications, and billing notifications. Message frequency varies. Message and data rates may apply. See privacy policy below. Message HELP for help. Reply STOP to any message to opt out.

Request an Appointment

Appointment Request Form

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