Scheduling Request | Broward Health

Please note, our Scheduling Department schedules appointments for:

Medical Appointments (Primary, Pediatrics and Specialties)
Medical Imaging (i.e. Radiology, Mammography, Computerized Tomography, MRI, Ultrasound, Nuclear Medicine and Pet Scans, Interventional Radiology
Cardio
Pulmonary
Sleep Disorder Studies
Neurodiagnostic Studies
BH Imaging (MRI and US, Mammo is coming soon!)

After filling out the required information, one of our staff will contact you within one business day to schedule your appointment or Diagnostic Procedure. If you would prefer to contact the Centralized Scheduling Department rather than utilize the electronic request, please call (954) 759-7500.

Patient's First Name

Patient's Last Name

Preferred Phone Numberplease enter as xxx-xxx-xxxx

Alternate Phone Numberplease enter as xxx-xxx-xxxx

Notes

Please Attach Diagnostic order. Please send scan or picture of the order.

List below the test(s) and any other information including Diagnosis(Dx) and/or ICD-10 codes that your Physician provided on the written order.

Use this property to display a short description or any instructions, notes, or guidelines that the visitor should read when filling out the form. This will appear directly below the content of the form.

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