Make an Appointment :: Wake Forest University Baptist Medical Center

Visitor Information > Make an Appointment > Appointment

This appointment is for:

you your spouse your child other

Your name if you are making the appointment for someone other than yourself:

The following information is for the person needing the appointment:

First Name:

Middle Name:

Last Name:

Address

City

State:

Zip:

Daytime Phone:

Alternate Phone:

The best time to reach you is:

From: To:

E-mail Address:

Date of Birth:

Are you currently seeing a WFU or Aegis physician?

If so, what is this physician's name?

Do you wish to make an appointment with this physician?

If not, with which physician?

Are you a new patient?

Preferred day for an appointment:

Time of day:

Second choice:

Time of day:

Reason for appointment/Symptoms:

Who is your primary care physician? (Some appointments
may require a referral from your primary care physician. )

Insurance Plan:

Employer:

How would you like us to confirm this appointment?

Telephone E-mail Either Both

Participating Health Plans

Health On-Call^®Locally: (336) 716-2255

Toll free: (800) 446-2255

- A free 24-hour service provided by Wake Forest University Baptist Medical Center

- Staffed by registered nurses

- Answers your health care questions

- Offers MD affiliation

- Can assist with making appointments

- Provides nurse triage for physicians after hours, on weekends and holidays

- Handles registration for BestHealth-sponsored seminars and screenings

Health On-Call is here for you and your family. Call us with your health questions, or complete and submit an Information Request Form.

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Copyright: Wake Forest University School of Medicine and North Carolina Baptist Hospitals. All rights reserved.
Medical Center Boulevard
Winston-Salem, NC 27157

The information on this Website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified healthcare provider. If you have a medical problem or a health-related question, consult your physician or call Health On-Call at 336-716-2255 or 1-800-446-2255.

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	Last Modified: 10/20/2009