Request an Appointment
If you are experiencing a medical emergency, please call 9-1-1. We cannot assist with emergency requests through this form.
In the comments area, be sure to tell us what information you need so that we can direct your request to the proper department for the fastest response.
We welcome your input and participation. Please note, however, that any complaints or comments regarding patient care for which you request a response must be directed to Halifax’s official complaints/grievances process, in compliance with HIPAA and other laws and regulations.