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        • Request an Appointment

          This form is for non-urgent appointments only. Appointment requests are processed in one to two business days.

          • Existing Henry Ford patients should request an appointment through MyChart
          • Log in to MyChart

          • If you do not have a MyChart account, sign up now
          • If you are having an emergency, call 911 or go to your nearest emergency room
          • Request a same-day primary care appointment
          • Call us:
            • Southeast Michigan Patients: (800) 436-7936
            • Jackson or South Central Michigan Patients: (517) 205-4800
          How Can We Help You?
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          Patient Information
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          Enter MM/DD/YYYY format
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          Insurance Information
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          Contact Name
           

          MyChart

          Henry Ford MyChart: all online and all for you.

          Learn More

          LiveWell Blog

          Wellness is a journey. Get tips from Henry Ford experts to keep you on track.

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          Schedule Appointment Online

          ** Check with your insurance carrier for coverage limitations.

          If you can't find a date/time that works for you please call the provider’s office. Not all appointment types at all locations are available online.

          Henry Ford Health System is committed to ensuring our Deaf or hard-of-hearing patients and visitors have equal access to all services. We provide the appropriate auxiliary aids and services, including qualified sign language interpreters, TTYs and other assistive listening devices, at no cost. To request assistance, call 313-916-1896 or email CommunicationAccess@hfhs.org.

          Schedule Appointment for

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