Request a Referral

In case of an emergency or if you are having severe symptoms, call 911. Do not use this form.

Thank you for contacting Baptist Health Systems for a physician referral. All our physicians are members of Baptist's medical staff. There is no fee to you or to the physician for this service. Physicians are selected according to your specific wants and needs.

After you complete and submit this form, a Baptist representative will respond to you via e-mail with physician information based on the answers you provide. To help us process your request promptly, please answer each question on the form.

If you need additional assistance, please call 948-6262 or 1-800-948-6262 Monday-Friday, 8:00 a.m. - 5:00 p.m.

:: Click here to request a physician referral.