The Brooklyn Heart Center Cardiology, Cardiac Testing and Cardiac Catheterization Lab IF THIS IS AN EMERGENCY PLEASE CALL 911 (DO NOT BOOK OR REQUEST AN APPOINTMENT) Request a Brooklyn Heart Center Appointment To request an appointment or more information from our Brooklyn Heart Center Team, please complete the form below. After you submit this information, a TBHC representative will contact you by phone within two business days. We can also be reached at 718.250.8267 on business days from 9 am – 5 pm. Please note that we accept most major insurance plans, including Medicare and Medicaid. * indicates required field Patient's First Name * Patient's Last Name * Sex * Male Female Decline to Answer Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018 Existing Patient * Yes No Health Insurance * Address City State Zip Code * Email Address * Phone * Preferred Contact Time * Reason for Visit or Information Request *
