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Outpatient Scheduling

Welcome to Holy Cross Hospital's online scheduling request portal.

This form may be used by physicians and their office personnel to request an outpatient diagnostic test in lieu of calling our scheduling department directly. Please be sure to provide all information requested.

If your patient is in need of an appointment within 48 hours (two business days) or if you are having technical difficulties, please contact the scheduling center directly at 954-202-0277. Our hours of operation are Monday through Friday from 8 a.m. to 5 p.m.

For patients over 70 having any exam that requires contrast, BUN-Creatinine lab tests must be completed prior to the exam and the results faxed to our scheduling department at 866-397-2465.

Please fill out the outpatient schedule form below:
Physician First Name *
Please enter your first name.


Physician Last Name *
Please enter your last name.


Physician Phone Number *
Please enter your phone no.


Patient First Name *
Please enter patient first name.


Patient Middle Name


Patient Last Name *
Please enter patient last name.


Patient Phone Number


Patient Date of Birth (mm/dd/yyyy)
     

Procedure *
Please enter procedure.


If "Other", please indicate





* = Required Field

If you have additional questions please contact our scheduling center at (954) 202-0277


 

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