Request Appointment

Complete the form below to receive a callback from one of our representatives confirming your appointment request. Alternatively, you can call +971 52 318 7270from 7:00 AM to 10:00 PM daily to speak to a representative.

 

Requester Information

Who is this appointment for?

Patient Information

Please provide patient information as it appears on legal documents.

Have you previously received care at Rashid Hospital?
The name of a parent is required if the patient is under the age of 16.

Medical Concern

What is the primary medical problem or diagnosis for the appointment request?

Important: After submission, please do not leave this form until you see the confirmation message.