East Alabama Medical Center

Appointment Request Form

If you are experiencing a medical emergency, call 911 or your local emergency access provider.

Please allow 24 hours for your request to be processed. After-hours submissions will be processed the next business day.

For same day or urgent radiology requests please call (334) 528-1156.

If you are unable to upload an electronic copy of supporting documentation, please fax it to (334) 528-3262.

Scheduling Department

Monday - Thursday 7:00AM - 5:30PM CST
Friday 7:00AM - 5:00PM CST

Fax
(334) 528-3262
Your Information
  Send Text/SMS confirmation.
Format: mm/dd/yyyy
XXX-XX-
Last 4 digits only
  Send Text/SMS confirmation.
 Send email confirmation.

Appointment
For same day or urgent radiology requests please call  (334) 528-1156
Type of Exam(s)
Type LAST FIRST to search physicians. 3 letter minimum.
Preferred Day
Preferred Time
Comments / Questions
Order/Prescription Upload

Scheduling Department

Monday - Thursday 7:00AM - 5:30PM CST
Friday 7:00AM - 5:00PM CST

Fax
(334) 528-3262

We understand that your privacy and security are of the utmost importance. For your peace of mind, registration information is encrypted in-transit utilizing industry standard technologies (SSL or TLS, depending on your device support). If you are experiencing technical problems submitting this online form, please contact EAMC Technical Support at (334) 528-6850.