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Online Appointment Request – Endocrinology

Online Appointment Request – Endocrinology

- 24 AUG 20
Online Appointment Request – Endocrinology
Thank you for requesting an appointment for Endocrinology Services at Artesia General Hospital.

Please complete the fields below and submit. Your request will go to a scheduler who will contact you by email or phone within one business day during regular business hours, Monday to Friday.

Please note: this appointment request is not for emergencies, same day or next day appointments. If you need an appointment within the next 48 hours, please contact us directly at our offices in Artesia (575.736.8440) or Carlsbad (575.736.8490).

OAR - Endocrinology

YOUR INFORMATION

First Name *

Last Name *

Address *

City *

State *

Zip *

Phone *

Email *

Preferred Contact Method *

Date of Birth *
MM/DD/YYYY

Insurance *

Which provider would you like to see? *

Robert T. Ferraro, MD, CDE

Susan Dade, RD, LD, CDE

No preference

Are you a new or existing patient? *

New patient

Existing patient

Choose your preferred location (check all that apply). *

Artesia

Carlsbad

No preference

What is the reason for your visit? *
What is the reason for your visit?

YOUR APPOINTMENT PREFERENCES

Which time(s) of the day would you prefer your appointment? (Check all that apply.) *

Morning (8:00 to 12:00 p.m.)

Afternoon (1:00 to 5:00 p.m.)

Which day(s) of the week would you prefer your appointment? (Check all that apply.) *

Monday

Tuesday

Wednesday

Thursday

Friday

Please provide any additional details about your request.

Consent Form *

I acknowledge that this appointment request form requires me to provide protected health information (PHI), which will be used to schedule an appointment at Artesia General Hospital. By submitting this form, I consent to this information being disclosed to the scheduling office, as well as receiving notifications via my requested communication method for scheduling purposes. If email is my preferred method, I understand I may receive unencrypted emails from a scheduler that may contain PHI, such as my name and the type of appointment I have requested.

If you are human, leave this field blank.
Physicians & Providers

Robert T. Ferraro, MD, CDE

Endocrinology

Susan Dade, RD, LD, CDE

Locations & Hours

Monday – Friday
8 am – 5 pm

Artesia
608 N. 13th St., Suite 600
Artesia, NM 88210
575.736.8440

Carlsbad
2319 W. Pierce St.
Carlsbad, NM 88220
575.736.8490

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