Request An Appointment

If you are experiencing a complex or emergency medical condition,
call your doctor, call 911 or go to the nearest emergency room.

Is this an urgent need or emergency*
Patient Status*
Is this appointment request for an existing or new patient?
Pediatric Specialty*
What specialty are you wanting to see?
If you are experiencing a complex or emergency medical condition, call your doctor, call 911 or go to the nearest emergency room.
Have you seen this specialty in the last 3 years at Norton Children's
Please go here to sign-up for MyChart and complete your appointment request there.
If you’re established with a pediatrician, please provide their name
Provider
If you have a preferred provider or location, please include
Do you have a primary language preference*
- English
- Spanish
Patient Name*
First Last
Patient Date of Birth*
Month
Day
Year
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Parent or Legal Guardian's Name*
First Last
Best way to contact me*
Is Appointment for an Auto Accident*
Is Appointment for an Workman's Compensation*
Symptoms or Reason for Appointment / Comments
CAPTCHA

Call For An Appointment

Call (502) 629-KIDS (5437) to request an appointment with a Norton Children’s provider.