Halifax Health Medical Center of Daytona Beach Emergency
Patients with more severe illness will be seen with priority. Please, only use this check-in process for an illness that is
not
life threatening.
Contact Information
Time slot:
11:00 AM Wednesday, August 04
11:30 AM Wednesday, August 04
12:00 PM Wednesday, August 04
12:30 PM Wednesday, August 04
01:00 PM Wednesday, August 04
01:30 PM Wednesday, August 04
02:00 PM Wednesday, August 04
02:30 PM Wednesday, August 04
03:00 PM Wednesday, August 04
First Name
Last Name
Gender
Date of Birth
Phone
Email
Have you visited this location before?
Symptoms
What symptoms are you experiencing? Please check all that apply.
Coughing
Diarrhea
Ear Ache
Fever
Muscle Aches
Nausea
Other (non life threatening)
Rash
Swelling
Important!
I understand that online check-in is not to be used for life threatening conditions. I do not believe that the patient's condition is life threatening.
I consent to being contacted by email and by phone.