Request an Appointment 
Thank you for requesting an appointment online. To request an appointment, please provide us with the information below. Just click on "Send Appointment Request" button when you are finished, and your request will go to a scheduling assistant. You will receive a response via e-mail or telephone within 48 hours (except on weekends and on holidays). A physician's prescription is required for your appointment. If you prefer to make an appointment by phone, please call 786-573-6000.

We respect your privacy, and all information is encrypted for your protection.

Before you submit a request for an appointment via our website, we are required by federal law to provide you with Baptist Health's Notice of Privacy Practices for your review.


I agree with terms for online appointments*
I acknowledge receipt of the Notice of Privacy Practices.*
Personal Information
First Name*
Middle Name
Last Name*
Birth Date*
Social Security Number
(for Example: 123-45-6789)
Gender*
Address*
City*
State*
Zip Code*
Appointment Information
Your appointment is for which of the following. (Check all that apply)*




















If you selected 'Other', please specify
What is the Diagnosis?*
Who is the ordering physician?*
What date would you prefer?*
Please select your appointment time preference*
Please select your location of preference*
Contact information
Please provide the best phone number to reach you and/or leave a detailed message regarding your appointment. A scheduling representative will contact you to confirm your appointment.
Best Daytime Phone Number*
Email Address*
Reconfirm Email Address*
Please be advised at the time of registration a representative from the Pre-Registration Department will contact you at the phone number given above
Primary Insurance Information
Insurance Company Name*
Policy Number*
Group Number*
Pre-certification or Benefits Phone Number(s)*
Secondary Insurance Information
Insurance Company Name
Policy Number
Group Number
Pre-certification or Benefits Phone Number(s)