International Contact Us Form
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Contact Us

Thank you for contacting Baptist Health International for assistance with your medical care. So that we can better protect your privacy, and provide you with prompt, personalized assistance, please complete the form below. Just click on the "Submit Information"​ button when you are finished, and your request will go to an International Services representative. You will receive a response via e-mail or telephone within 48 hours.

We respect your privacy, and all information is encrypted for your protection.

Before you submit a request for assistance via our website, we are required by United States law to provide you with Baptist Health's Notice of Privacy Practices​ for your review.

Contact Information
Last Name*
First Name*
Middle Name
Date of birth*
(Please enter mm/dd/yyyy)
Postal Code
How would you prefer to be contacted?
Home Phone*
(Please include country and city codes)
Other Phone
Email Address
Medical Information
Medical services requested*
Proposed Travel Dates
How did you hear about Baptist Health South Florida?