Ultrasound Appointment Request

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

Date of Birth (required)*

Select your birth month from the dropdown, then enter your birth day, followed by your birth year.
E.g. January 01, 1990

Do you currently have an order from your Physician? (required)*

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