Request an Appointment

We make scheduling appointments easy. Whether you are a new patient or existing patient, you can use our convenient online appointment request form to schedule an appointment today. Simply fill out the form, press submit, and we will contact you within one working day.

Remember, our office is only open Monday, Wednesday, and Friday. So expect a call or email response back anytime during those days. You can also contact us directly by calling 913-397-6900 to request your appointment with Dr. Tim Bhakta.

Appointment Request Form

*First Name:
*Last Name:
*Email:
*Phone:
Preferred Contact Method:
Are you a new or existing patient?
How did you hear about our practice?
Let us know who referred you. ‡
Insurance or Self Pay?
What day would you prefer?
What time of day do you prefer?
What would you like to see Dr. Tim for?
Other questions or comments: