Central Scheduling Reservation

Patient Access Department

Call us at 504.349.6300 or at 1.800.481.0645. Our offices are open from 7am - 5pm Monday through Friday.

Please fax orders to 504.349.6024.

  • Identification
  • Please enter your first name.
  • Please enter your last name.
  • Please make a selection.
  • Please make a selection.
  • Please enter a date.
  • Please enter your SSN.
  • This isn't a valid phone number.
    Please enter your phone number.
  • This isn't a valid phone number.
  • This isn't a valid email address.
    Please enter your email address.
  • Please enter your street address.
  • Please enter your city.
  • Please enter your state.
  • Please enter your zip code.
  • Please make a selection.
  • Please enter your employer's last name.
  • This isn't a valid phone number.
    Please enter your employer's phone number.
  • Appointment Information
  • Please enter your procedure.
  • Please enter your procedure's code.
  • Please enter the department involved.
  • Please enter the ordering physician's name.
  • Medical Information
  • Please enter your diagnosis.
  • Please enter your diagnosis code.
  • Please enter your admitting physician's name.
  • Please enter your primary care physician's name.
  • Please enter a date.
  • Please enter the procedure's name.
  • Insurance Information, Plan 1
  • Please enter your insurance carrier's name.
  • This isn't a valid phone number.
    Please enter your insurance's phone number.
  • Please enter your group name.
  • Please enter your group number.
  • Please enter your policy number.
  • Please enter your subscriber name.
  • Please enter the subscriber's SSN.
  • Please enter your group name.
  • Insurance Information, Plan 2 (if exists)
  • Medical Information
    (Please include any information pertinent to scheduling procedure)
  • Requestor Information
  • Please enter a date.
  • Please enter a date.
  • Please enter the requestor's name.
  • This isn't a valid phone number.
    Please enter the requestor's phone number.
  • This isn't a valid email address.
    Please enter the requestor's email address.