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Forest Park Email

This form will generate an e-mail to Mercy Family Clinic - Forest Park.

Please be aware of the following if you contact us by e-mail:

  • Do NOT use e-mail to seek urgent or emergent medical attention. If you are in need of immediate medical care, please go to the nearest emergency department or call 911.

  • You will not receive an e-mail response from the clinic. Your message will be reviewed and a clinic associate (not a physician) will contact you by phone as soon as possible and no longer than within 1 business day.

* Indicates required information
Patient Name: * 
Contact Name: (if different than above) 
Daytime Telephone Number: * 
Patient date of birth: *  (mm/dd/yyyy)
Email: * 
Check the reason for your request 

Appointment scheduled for 2 days out:  (mm/dd/yyyy)
Brief description of request: 
Acknowledgement * 
Authentication * 

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©  2015 

 Mercy Medical Center-North Iowa | 1000 4th Street SW Mason City, IA 50401 | 641-428-7000


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