MRI Appointment Request

MRI Appointment Request Main Content

Thank you for choosing Baptist Health, we're here to help you book a convenient appointment for your imaging study. It's quick and easy!

Complete the form below
A member of our scheduling team will call you to book an appointment

By submitting this request form, you are authorizing Baptist to contact you using the methods you provide below.

Patient Information

First Name	Last Name
Date of Birth

Email Address

Primary Phone Number	Primary Phone Number Type
Secondary Phone Number	Secondary Phone Number Type

Referring Physician's Name

Referring Practice

Referring Physician Phone Number

Do you currently have an order from your Physician?

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AccountID

CaseId

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Your request was submitted

Thank you for your imaging appointment request. A Baptist Health coordinator will call you within two business days to schedule an appointment date, time and location. During that telephone call, you’ll receive instructions so you can get ready for your imaging test, and other information you may need for your visit.

In the meantime, if you have any question, feel free to call us at 904.202.2222.

What are my options?

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MRI Appointment Request Main Content

Patient Information

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Your request was submitted