MyChart - Request an Appointment

Thank you for choosing Duke Health. We look forward to caring for you. Please fill out this form and a Duke representative will call you back within 1 to 2 business days in order to schedule your appointment.

NOTE: If you are having a life-threatening medical emergency, please call 911 or proceed to the nearest emergency room. For urgent care needs, please visit a Duke Urgent Care clinic.

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Please indicate your relationship to the patient*:

Patient Information:

First Name*:

Last Name*:

Date Of Birth*:

(MM-DD-YYYY)

Email Address*:

Your email will only be used if we cannot reach you by phone.

Best Contact Phone Number*:

We will contact you between 8:00am-5:00pm, Monday - Friday

Specialty*:

You can make appointments with many of our doctors but some specialized care requires a referral. If a referral is required, a Duke Health scheduling representative will contact you with additional information.

Reason for Visit:

If you have a concern about COVID-19 infection or have flu-like or upper respiratory symptoms, please call your Duke primary care doctor. If you do not have a Duke primary care doctor, please call the Duke COVID-19 Hotline at 919-385-0429, 8:00 am - 8:00 pm seven days a week.

If you need further help scheduling an appointment not related to COVID-19 or respiratory symptoms, you may also contact us at 1-888-275-3853 for assistance.