Hang tight while we prepare your form...

This form may capture sensitive data (credit cards, bank accounts…), yet this site isn’t sufficiently secured.

Please contact the site administrator to resolve this issue. He must enable SSL.

This form failed to load. Try reloading this page.

The server may be having issues, or this website’s administrator may have deleted the form.

Office Hours:

Monday-Thursday 9AM-4PM

*Temporary Covid Hours by appointment only.


Office Phone: 

(918) 835-8426


Email:

aa.mdumc@tulsacoxmail.com


Address:

7903 E 15th St

Tulsa, OK 74112