Request an Appointment at Scott & White

Before you begin, please note...

This online appointment request service is for advance appointment scheduling only. For same-day appointment requests, please phone the Scott & White location you'd like to visit. For a medical emergency, please phone 911.
The information you provide in this form is secure and confidential. Scott & White respects your privacy.
* Required information is marked with an asterisk (*) and must be completed before you can submit the appointment request.
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What You'll Need to Complete This Form


  • The patient's legal name, date of birth, home address and primary phone number
  • The patient's preferred contact method (phone or email)
  • For new patients of Scott & White who will be paying with insurance, the patient's health insurance provider name, customer service phone number and patient identification number (View a list of accepted insurance plans)

    Note: Scott & White also accepts payment by cash, check, Visa, MasterCard, American Express and Discover cards, money orders and travelers checks.


  • The name of the patient's Scott & White primary care physician or the name of the Scott & White health care provider the patient would like to see (Find a provider)
  • The patient's preferences for when to schedule the appointment