Request an appointment at MedStar Washington Hospital Center

To request an appointment, please fill out the form below. If you have any questions or would like to make an appointment by phone, please call the DOCS line at 202-877-DOCS.


In order for you to request an appointment electronically, you will need to provide confidential medical information. By proceeding through this notice and providing the requested demographic and medical information, you consent to the disclosure of such information to the relevant MedStar Washington Hospital Center clinical staff. The information that you provide will be placed into our electronic database. Your specific information will be accessed and used only for scheduling purposes. Aggregate data (without patient identifiers) may be analyzed at a later date. The information that you provide will not be shared with other organizations, and cookies or other tracers will not be used to collect information or track your computer use. If you do not wish to transmit your medical information electronically, you should call MedStar Washington Hospital Center at 202-877-DOCS to request an appointment.

Appointment For:

* Indicates required field
Patient's Name *
Address *
City *
State *
Zip *
Country
Date of Birth *
Gender * Male Female
Health Insurance Provider(HIP) *
Insured's Name
Where to contact you:

Name(if different from patient name)
Email Address
Daytime Phone *
Evening Phone *
Appointment Information:

Referring Physician(if applicable)
Requested Physician
Have you seen this physician before? Yes No
Have you been a MedStar Washington Hospital Center patient in the past? Yes No
Please tell us about your medical condition and what type of appointment you are requesting. *
How did you hear about us? *
 
Please indicate when we can reach you during the day
between 8:30 AM and 4:30PM.
All times are Eastern Standard Time(USA).*