michaelbuckmire.leonardo-sites.com
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52.39.109.56
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URL:
https://michaelbuckmire.leonardo-sites.com/
Submission: On August 13 via api from US — Scanned from DE
Submission: On August 13 via api from US — Scanned from DE
Form analysis 2 forms found in the DOM
POST #
<form data-v-0d3a5668="" id="contact-form" method="post" action="#" role="form"><input data-v-0d3a5668="" type="hidden" name="valueid">
<div data-v-0d3a5668="" class="col-md-6"><label data-v-0d3a5668="">First Name <span data-v-0d3a5668="" style="color: rgb(255, 0, 0);">*</span></label> <input data-v-0d3a5668="" name="firstname" type="text" required="required" class="form-control">
</div>
<div data-v-0d3a5668="" class="col-md-6"><label data-v-0d3a5668="">Last Name <span data-v-0d3a5668="" style="color: rgb(255, 0, 0);">*</span></label> <input data-v-0d3a5668="" name="lastname" type="text" required="required"></div>
<div data-v-0d3a5668="" class="col-md-6"><label data-v-0d3a5668="">Phone <span data-v-0d3a5668="" style="color: rgb(255, 0, 0);">*</span></label> <input data-v-0d3a5668="" name="phone" type="text" required="required"></div>
<div data-v-0d3a5668="" class="col-md-6"><label data-v-0d3a5668="">Email <span data-v-0d3a5668="" style="color: rgb(255, 0, 0);">*</span></label> <input data-v-0d3a5668="" name="email" type="text"></div>
<div data-v-0d3a5668="" class="col-md-12"><label data-v-0d3a5668="">Message</label> <textarea data-v-0d3a5668="" id="form_message" name="message" rows="4" data-error="Please, leave us a message." class="form-control"></textarea>
<div data-v-0d3a5668="" id="req_fld" class="col-md-12">
<p data-v-0d3a5668="" class="form-req"><strong data-v-0d3a5668="" style="color: red;">*</strong> <em data-v-0d3a5668="">Required Fields</em></p>
</div>
</div>
<div data-v-0d3a5668="" id="phiWidth" class="row">
<div data-v-0d3a5668="" id="phiContainer" class="col-md-12">
<h5 data-v-0d3a5668=""><b data-v-0d3a5668="">Important Notice Concerning Personal Health Information:</b></h5>
<div data-v-0d3a5668="" id="chbxPHI">
<table data-v-0d3a5668="">
<tbody data-v-0d3a5668="">
<tr data-v-0d3a5668="">
<th data-v-0d3a5668="" style="vertical-align: top;"><input data-v-0d3a5668="" type="checkbox" name="consent" value="consent" required="required"></th>
<td data-v-0d3a5668="">
<p data-v-0d3a5668="" style="font-size: 12px; padding-left: 10px;">I agree to allow my healthcare provider or facility staff to reply to the email address indicated on this form, and to forward or share the information contained in
this form, including any <b data-v-0d3a5668="">Personal Health Information (PHI)</b>, with other health professionals or associated staff using non-secure electronic communication methods such as email.</p>
<p data-v-0d3a5668="" style="font-size: 12px;"><b data-v-0d3a5668="">Please contact our office by telephone if
you prefer <u data-v-0d3a5668="">NOT</u> to share Personal Health Information using
non-secure methods.</b></p>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<div data-v-0d3a5668="" class="col-lg-12 row"><label data-v-0d3a5668="">CAPTCHA - Security Check<span data-v-0d3a5668="" style="color: red;">*</span></label>
<p data-v-0d3a5668="" style="line-height: 24px;">Type the characters you see in the box. Characters are case sensitive.</p>
</div>
<div data-v-0d3a5668="" class="col-lg-12 row" style="margin-bottom: 15px;"><input data-v-0d3a5668="" type="text" maxlength="80" id="captcha" name="captcha"
style="width: 202px; height: 30px; padding: 0px 5px; border: 1px solid rgb(153, 153, 153);"> <br data-v-0d3a5668=""> Unable to read the characters? <a data-v-0d3a5668="" href="javascript:void(0);">RELOAD NEW CHARACTERS</a><br
data-v-0d3a5668=""> <img data-v-0d3a5668="" id="captcha_code" src="captchacode.php?form=contactpage" alt="CAPTCHA Display"></div>
</div>
<div data-v-0d3a5668="" class="col-md-2 col-md-offset-5"><input data-v-0d3a5668="" type="button" id="sendMsg" value="SEND MESSAGE" class="btn btn-success btn-send"></div>
</form>Name: apptform —
<form id="apptform" name="apptform">
<div class="col-md-6 col-sm-6 col-xs-12 appoint-left">
<div class="row">
<div class="col-md-12 form-wrap">
<div class="row dr-appoint-profile">
<div class="dr-appoint-pic col-xs-4 col-lg-4"><img src="https://sitebuilder.dr-leonardo.com/leonardo_design_files/leonardo_tmpls/Thefourteenth/assets/images/provider-placeholder.jpg"></div>
<div class="dr-nme-addr col-xs-8 col-lg-8"><span class="bok-dr-name">Select Provider</span> <select>
<option disabled="disabled" value="" selected="selected">Please select one</option>
<option value="[object Object]"> Michael Buckmire </option>
</select> <br> <span class="bok-dr-name">Select Location</span> <select required="required" class="slct-loc col-md-10" style="margin-right: 3px; width: 165px;">
<option disabled="disabled" value="" selected="selected">Please select one</option>
<option value="[object Object]">Advanced Surgical Associates - 2945 S Dobson Rd</option>
</select> <br> <label>Preferred Appointment Time</label> <select required="required" class="slct-loc">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select> <select required="required" class="slct-loc">
<option value="00">00</option>
<option value="15">15</option>
<option value="30">30</option>
<option value="45">45</option>
</select> <select required="required" class="slct-loc">
<option selected="selected">AM/PM</option>
<option value="am">AM</option>
<option value="pm">PM</option>
</select></div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-offset-1 col-xs-10 col-md-offset-1 col-md-10 calendar-bx">
<div class="col-md-8 col-md-offset-2">
<div class="dte-time-cont center-block"><label><span class="book-wk-day">Tuesday</span> - <span class="book-date">08/13/2024 02:06</span></label></div>
</div> <br>
<div class="row">
<div data-role="date-picker" id="datepicker" class="center-block" style="width: 270px;">
<table role="grid" style="width: 100%;">
<thead>
<tr>
<td><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><i class="glyphicon glyphicon-chevron-left"></i></button></td>
<td colspan="5"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><b>2024 August</b></button></td>
<td><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><i class="glyphicon glyphicon-chevron-right"></i></button></td>
</tr>
<tr align="center">
<td width="14.2857142857%"><small>Sun</small></td>
<td width="14.2857142857%"><small>Mon</small></td>
<td width="14.2857142857%"><small>Tue</small></td>
<td width="14.2857142857%"><small>Wed</small></td>
<td width="14.2857142857%"><small>Thu</small></td>
<td width="14.2857142857%"><small>Fri</small></td>
<td width="14.2857142857%"><small>Sat</small></td>
</tr>
</thead>
<tbody>
<tr>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">28</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">29</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">30</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">31</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">1</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">2</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">3</span></button></td>
</tr>
<tr>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">4</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">5</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">6</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">7</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">8</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">9</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">10</span></button></td>
</tr>
<tr>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">11</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">12</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-info btn-sm" style="border: none;"><span data-action="select" class="">13</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">14</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">15</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">16</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">17</span></button></td>
</tr>
<tr>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">18</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">19</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">20</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">21</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">22</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">23</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">24</span></button></td>
</tr>
<tr>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">25</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">26</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">27</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">28</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">29</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">30</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="">31</span></button></td>
</tr>
<tr>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">1</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">2</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">3</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">4</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">5</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">6</span></button></td>
<td><button data-action="select" type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span data-action="select" class="text-muted">7</span></button></td>
</tr>
</tbody>
</table>
<table role="grid" style="width: 100%; display: none;">
<thead>
<tr>
<td><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><i class="glyphicon glyphicon-chevron-left"></i></button></td>
<td colspan="4"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><b>2024</b></button></td>
<td><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><i class="glyphicon glyphicon-chevron-right"></i></button></td>
</tr>
</thead>
<tbody>
<tr>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>January</span></button></td>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>February</span></button></td>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>March</span></button></td>
</tr>
<tr>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>April</span></button></td>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>May</span></button></td>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>June</span></button></td>
</tr>
<tr>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>July</span></button></td>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-primary btn-sm" style="border: none;"><span>August</span></button></td>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>September</span></button></td>
</tr>
<tr>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>October</span></button></td>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>November</span></button></td>
<td colspan="2" width="33.333333%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>December</span></button></td>
</tr>
</tbody>
</table>
<table role="grid" style="width: 100%; display: none;">
<thead>
<tr>
<td><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><i class="glyphicon glyphicon-chevron-left"></i></button></td>
<td colspan="3"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><b>2020 ~ 2039</b></button></td>
<td><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><i class="glyphicon glyphicon-chevron-right"></i></button></td>
</tr>
</thead>
<tbody>
<tr>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2020</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2021</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2022</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2023</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-primary btn-sm" style="border: none;"><span>2024</span></button></td>
</tr>
<tr>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2025</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2026</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2027</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2028</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2029</span></button></td>
</tr>
<tr>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2030</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2031</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2032</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2033</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2034</span></button></td>
</tr>
<tr>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2035</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2036</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2037</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2038</span></button></td>
<td width="20%"><button type="button" class="btn btn-block btn-default btn-sm" style="border: none;"><span>2039</span></button></td>
</tr>
</tbody>
</table>
<div><br>
<div class="text-center"><button data-action="select" type="button" class="btn btn-info btn-sm">Today</button> <button data-action="select" type="button" class="btn btn-default btn-sm">Clear</button></div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-12 appoint-right form-appoint-details">
<div class="row">
<div class="col-md-12 form-wrap">
<div class="row">
<div class="col-md-12 text-center left-date"> <span class="left-time"></span></div>
</div>
<div class="col-md-4 col-xs-12 frm-rw-spce frm-col-pad-rht"><label>First Name <span>*</span></label> <input type="text" name="FirstName" required="required"></div>
<div class="col-md-8 col-xs-12 frm-rw-spce frm-col-pad-lft"><label>Last Name <span>*</span></label> <input type="text" name="LastName" required="required"></div>
<div class="col-md-4 col-xs-12 frm-rw-spce frm-col-pad-rht"><label>Phone # <span>*</span></label> <input type="text" name="Phone" required="required"></div>
<div class="col-md-8 col-xs-12 frm-rw-spce frm-col-pad-lft"><label>Mobile Phone #</label> <input type="text" name="Phone"></div>
<div class="col-md-12 col-xs-12 frm-rw-spce"><label>Email <span>*</span></label> <input type="email" name="Email" required="required" class="form-control"></div>
<div class="col-md-4 col-sm-4 col-xs-4 frm-rw-spce frm-col-pad-rht"><label>New Patient <span>*</span></label> <select id="NewPatient" name="NewPatient" required="required" class=" form-control" style="width: 100%;">
<option value="1">Yes</option>
<option value="0">No</option>
</select></div>
<div class="col-md-8 col-sm-8 col-xs-8 frm-rw-spce frm-col-pad-lft"><label>Preferred Contact Method <span>*</span></label> <select id="preferred_contact_method" name="Preferred_Contact_Method" required="required" class=" w-full form-control">
<option selected="selected" value="">Please select one</option>
<option value="phone">Phone</option>
<option value="text">Text</option>
<option value="email">Email</option>
</select></div>
<div class="col-md-12 col-sm-12 col-xs-12 frm-rw-spce frm-col-pad-rht"><label>Type of Appointment Request</label> <select id="appointment_type" name="appointment_type" class=" w-full form-control">
<option selected="selected" value="">Please select one</option>
<option value="in-office">In-office Visit</option>
<option value="telemedicine">Telemedicine Visit</option>
</select></div>
<div class="col-md-12 col-sm-12 col-xs-12 frm-rw-spce"><label>Reason for Visit</label> <textarea name="Message"></textarea></div>
<div class="row">
<div class="col-md-12 col-sm-12 col-xs-12"></div>
</div>
<div class="row">
<div class="col-md-offset-4 col-md-8 col-sm-8 col-xs-8"><button type="submit" class="btn-rqust-app"> Request Appointment</button></div>
</div> <br>
</div>
</div>
</div>
</form>Text Content
Menu * HOME * ABOUT * OFFICE POLICIES * PATIENT PORTAL * PATIENT EDUCATION * ANAL FISSURE * SPHINCTEROTOMY * FISTULOTOMY * ANAL STENOSIS * ANORECTAL MANOMETRY * ANOSCOPY * ANOPLASTY * ANAL FISTULA * HEMORRHOIDS * HEMORRHOIDS FAQS * ANAL PAIN * FECAL INCONTINENCE * COLON RESECTION * COLONOSCOPY * COLORECTAL CANCER * COLOSTOMY * DIVERTICULITIS * ILEOSTOMY * ISCHEMIC COLITIS * PROCTITIS * RECTAL CANCER * RECTAL PROLAPSE * RECTOCELE * PILONIDAL CYST REMOVAL * FLEXIBLE SIGMOIDOSCOPY * LOCATION MICHAEL BUCKMIRE MD ADVANCED SURGICAL ASSOCIATES COLON & RECTAL SURGERY Suggested Reading Call Appointments Credentials Insurances Locations Connect Michael Buckmire MD Advanced Surgical Associates 2945 S Dobson Rd Mesa, AZ 85202-7980 480-969-4138 Main -------------------------------------------------------------------------------- ADDITIONAL INFORMATION Years in practice Male Languages * English Additional Information Hide Content -------------------------------------------------------------------------------- SOCIAL MEDIA -------------------------------------------------------------------------------- ABOUT Thank you for visiting my personal professional website. I specialize in Colon and Rectal Surgery and I am fully trained and experienced in a wide variety of conditions and disorders associated with my specialty. My staff and I strive to provide the highest standard of care and compassion to each of my patients. -------------------------------------------------------------------------------- Professional Skills: * Healthcare Management -------------------------------------------------------------------------------- WORK EXPERIENCE * Advanced Surgical Associates Colorectal surgeon -------------------------------------------------------------------------------- PAYMENT OPTIONS * American Express * Discover * MasterCard * Visa -------------------------------------------------------------------------------- PATIENT EDUCATION * Anal Fissure * Anal Fistula * Anal Pain * Anal Stenosis * Anoplasty * Anorectal Manometry * Anoscopy * Colon Resection * Colonoscopy * Colorectal Cancer * Colostomy * Diverticulitis * Fecal Incontinence * Fistulotomy * Flexible Sigmoidoscopy * Hemorrhoids * Hemorrhoids FAQs * Ileostomy * Ischemic Colitis * Pilonidal Cyst Removal * Proctitis * Rectal Cancer * Rectal Prolapse * Rectocele * Sphincterotomy Show More Patient Education -------------------------------------------------------------------------------- LOCATIONS Michael Buckmire MD Advanced Surgical Associates 2945 S Dobson Rd Mesa, AZ 85202-7980 Phone: 480-969-4138 Sunday 9:00 - 5:00 Monday 9:00 - 5:00 Tuesday 9:00 - 5:00 Wednesday 9:00 - 5:00 Thursday 9:00 - 5:00 Friday 9:00 - 5:00 Saturday 9:00 - 5:00 CONTACT IMPORTANT: Do Not Use This Form in the Event of an Emergency! First Name * Last Name * Phone * Email * Message * Required Fields IMPORTANT NOTICE CONCERNING PERSONAL HEALTH INFORMATION: I agree to allow my healthcare provider or facility staff to reply to the email address indicated on this form, and to forward or share the information contained in this form, including any Personal Health Information (PHI), with other health professionals or associated staff using non-secure electronic communication methods such as email. Please contact our office by telephone if you prefer NOT to share Personal Health Information using non-secure methods. CAPTCHA - Security Check* Type the characters you see in the box. Characters are case sensitive. Unable to read the characters? RELOAD NEW CHARACTERS Terms of Use Website Privacy Policy Notice of Privacy Practices Patient Portal Copyright © 2024 by Michael Buckmire MD and Dr. Leonardo Interactive Webservices, LLC. All Rights Reserved. × SCHEDULE AN APPOINTMENT Select Provider Please select one Michael Buckmire Select Location Please select one Advanced Surgical Associates - 2945 S Dobson Rd Preferred Appointment Time 123456789101112 00153045 AM/PM AM PM Tuesday - 08/13/2024 02:06 2024 August SunMonTueWedThuFriSat 28293031123456789101112131415161718192021222324252627282930311234567 2024 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 2020 ~ 2039 20202021202220232024202520262027202820292030203120322033203420352036203720382039 Today Clear First Name * Last Name * Phone # * Mobile Phone # Email * New Patient * Yes No Preferred Contact Method * Please select one Phone Text Email Type of Appointment Request Please select one In-office Visit Telemedicine Visit Reason for Visit Request Appointment