EJGH - HealthFinder

	Find a Physician
	Physician Appointments and Referrals
	Classes and Education
	Support Groups

Welcome to East Jefferson General Hospital's on-line physician referral and appointment service. We are available to provide physician referrals or appointments Monday through Friday from 8 a.m. to 4:30 p.m. After hours and on weekends, we will respond to your request within two hours of the start of the next business day.

If this is urgent, please call (504) 456-5000 during regular hours to speak with a Health Finder Representative for immediate help. If this is an emergency, please call 9-1-1 or proceed to the nearest emergency room. For more information on our physician referral and appointment service, please call (504) 456-5000.

Your Information:

First Name:
Last Name:
Email Address:
Gender:		Male Female

Patient Information:

First Name:

Last Name:

Gender:

Male Female

Street Address:

City, State, Zip Code:

Daytime Phone:
Evening Phone:
Date of Birth:

Name of patient's insurance company: (if applicable)

I have (an)

HMO PPO POS Medicare HMO

I have

Medicare Medicaid Both No Coverage

Contact me by:

Phone Letter Email

I wish to receive/make:

MD Referral Appointment

Please schedule my appointment on:

Monday
Tuesday
Wednesday
Thursday
Friday

Early a.m.
Mid a.m.
Midday
Early p.m.
Late p.m.

I need a specialist in the field of:

Allergy & Immunology Cardiology Colon & Rectal Surgery Dermatology Endocrinology Family Practice Gastroenterology General Surgery	Gynecology/Obstetrics Internal Medicine Neurology Other Oncology/Hematology Ophthalmology Orthopedic Surgery Otolaryngology	Pediatrics Plastic Surgery Podiatry Pulmonary Psychiatry Radiation Oncology Rheumatology Urology
Please add any additional information that may be useful in finding a Physician to meet your needs. Be sure to include the reason for your appointment.

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