Forms

Welcome to the Forms page of Rankin Rural, your trusted Hometown healthcare provider. Here you can easily access and complete important forms for your appointments. Simplify your visit by filling out these forms before your appointment.

View our Forms

Download and print prior to your appointment.

 

To better serve our current and new patients, and minimize your wait time, we now offer many of our forms for download and printing before your appointment. Completing these forms beforehand helps ensure a quicker and more efficient visit. Bring your forms.

New Patient Packet

 

Nurse with medicaid patient at family clinic

Contact Rankin Rural Medical Clinic

Contact Rankin Rural Medical Clinic
If this is an emergency, please dial 911 immediately. Do NOT enter any protected health information using the contact form.
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Rankin Rural will respond to messages within 24-48 hours or 2 business days. For immediate connection, please call our office. Do NOT submit any protected health information via this form.

Email

schedule@rankinrural.com

Address

129 Center St. Suite B Richland, MS 39218

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Rankin Rural Medical Clinic

Your Hometown healthcare provider dedicated to offering high-quality, affordable medical services to Central Mississippi.

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Contact Rankin Rural:

(P) 769-233-7141

(F) 769-233-7226

schedule@rankinrural.com
129 Center St. Suite B, Richland MS 39218

Hours:

Monday-Thursday 8-5 PM

Friday 8-12PM