Request an Appointment
Physicians
If you are a physician and would like to refer a patient to Kings & Queens Teaching Hospital, do not use the form below. Please use our physician online referral form
Patients
To request an appointment with Kings & Queens Teaching Hospital Physician, please complete the form below. Kings & Queens Teaching Hospital representative will contact you within immediately. If you need immediate assistance, please call our representatives at +233-000-0000. Use our Appointment Scheduling Phone Directory to view a list of Kings & Queens Teaching Hospital scheduling numbers.
If you are having a medical emergency – please call +233-240-000000.
Fields marked with "«" are required.
Patient Information
Patient First name«
Patient Middle initial
Patient Last name«
Date of Birth«
(mm/dd/yyyy)
Patient Gender« Female
Male
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