Appointments Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.Please complete the following form to request an appointment. Please also note that availability will vary depending on your request. Your appointment will be confirmed by phone by a member of our staff. Thank you!Name* Phone* Email* Preferred Location* Creve Coeur Washington Kirkwood Farmington Which doctor would you prefer to see?* Brittany R. Staples, DPM Carmina Quiroga, DPM Dr. H. John Visser Jared J. Visser, DPM Karl Collins, DPM FACFAS Rekha N. Kouri, DPM Robert K. Duddy, DPM Shirley C. Visser, DPM No preference, first available Preferred Date* MM slash DD slash YYYY Preferred Time* Morning Afternoon Evening No preference, first available Nature of Visit*CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.