Book Your Appointment

Schedule your visit with our healthcare professionals

Appointment Request Form

First Name *

Last Name *

Email Address *

Phone Number *

ID Number/Passport *

Select Department *

Preferred Doctor (Optional)

Preferred Date *

Preferred Time *

Reason for Visit *

Is this your first visit to our hospital?

Yes

Medical History (Optional)

Do you have medical insurance?

Yes

Emergency Contact Name

Emergency Contact Phone

I consent to Mary Immaculate Kerugoya Hospital collecting and processing my personal and medical information for the purpose of providing healthcare services. *

I agree to the terms and conditions and understand that this is a booking request that will be confirmed by the hospital. *

We will contact you within 24 hours to confirm your appointment.

Important Information

Appointments are confirmed within 24 hours
Bring your ID and insurance card
Arrive 15 minutes before your appointment
Cancel at least 24 hours in advance