Non-Urgent Appointment Request


If you are experiencing Chest Pain please proceed to the nearest emergency room. If you have Shortness of Breath please call 911. Inform staff if you believe it is COVID-19 related.
Language(Required)
Patient Name(Required)
MM slash DD slash YYYY
If other than patient
Callbacks available from 8am to 4:30pm.
Doctor(Required)
MM slash DD slash YYYY

Please Provide Current Insurance Information if Available.

Medical Questions

Are you experiencing any respiratory symptoms?(Required)
If YES, please select:
Have you been exposed to the flu or COVID-19?(Required)
Have you or anyone you know traveled outside of the United States recently?(Required)
This field is for validation purposes and should be left unchanged.
You will be contacted to schedule your appointment as soon as possible.
El Campo Memorial Hospital (ECMH) and its predecessor have been providing the highest quality medical care in El Campo for over 68 years, and at the current location since 1979.The hospital is accredited by state and federal regulations (Medicare/Medicaid). Patient Billing: Various physicians involved in your care at ECMH will bill you directly for their services. These may include your anesthesiologist, emergency room physician(s), radiologist, pathologist, cardiologist or other consulting physician during your ER visit or hospital stay. Please remember that some physicians are private practitioners (contracted by ECMH and not an actual employee of ECMH) and may not be a provider on your specific managed care plan.
Pricing Transparency