We understand that busy days with work and kids can make you forget about that appointment you have been meaning to schedule. Therefore, we have designed the online appointment request form for you to fill out. Call 504-885-4223 or send an appointment request using our secure form and someone from our patient access department will respond promptly to your request. Patients needing an x-ray or lab performed at East Jefferson Imaging Center can walk in without an appointment.

Please remember to bring with you at the time of your visit:

• Picture ID
• Insurance Information
• Signed Physician Order

Disclaimer: This is not an official signed physician order. A signed physician order is required before your appointment arrival. This is meant as a request. Following a phone call from patient access, your official date and time will be confirmed.

Your Information

Name of your insurance company: (if applicable)

My appointment preference is:

What kind of appointment do you want to schedule? (check all that apply)

Have you had any imaging performed at East Jefferson General Hospital previously?

Additional Comments:

Disclaimer: This is not an official signed physician order. A signed physician order is required before your appointment arrival. This is meant as a request. Following a phone call from patient access, your official date and time will be confirmed.