Baptist Health Mission

As a witness to the love of God through Jesus Christ, Baptist Health exists as a voluntary, not-for-profit organization to promote and improve the physical, emotional, and spiritual well-being of the people and communities it serves through the delivery of quality health care services provided within a framework of fiscal responsibility.

Referrals & Forms

Montgomery Cancer Center Treatment Referral Forms

We provide treatment services to patients with a wide range of chronic conditions. Our new patient intake team may be reached Monday through Friday from 8:00am—4:30pm at (334) 273-3000, select option #1. If you receive a voicemail, please leave a message with your callback information.

Send a referral via fax to (334) 260-2011.

 

Patient Forms

New Patient Referral
Phone: (334) 273-3000—option #1   Fax: (334) 260-2011

Authorization to Request Medical Records
Phone: (334) 747-4792   Fax: (334) 260-2010

Patient History Form