Mayo eConsult

St. Luke's Emergency Department

First Available Time :

UnityPoint Clinic - Express (Peck's Landing)

1940 Blairs Ferry Road
Suite 104
Hiawatha, Iowa 52233

Closed Patients
Waiting Now

Urgent Care - Anamosa

1795 Hwy 64 East
Anamosa, Iowa 52205

Closed Patients
Waiting Now

Urgent Care - Hiawatha

1001 N. Center Point Road
Suite A
Hiawatha, Iowa 52233

Closed Patients
Waiting Now

Urgent Care - Marion

2992 7th Ave.
Marion, Iowa 52302

Closed Patients
Waiting Now

Urgent Care - Westside

2375 Edgewood Rd SW
Cedar Rapids, Iowa 52404

Closed Patients
Waiting Now

Request for eConsult

**Please ensure that a signed Authorization to Release information is completed by the patient and fax it to the eCoordinator at (319) 368-5581 along with all other supporting results/reports from your EHR/EMR.

It is critical you include all requested information below so we can ensure your consult is what you need.**

Patient Information

Gender *

Pediatric patients (<18 years="" of="" age)="" require="" parent/guardian="" name="" and="" phone="">

Physician Information

What is the purpose of this eConsult? (Please check all that apply and provide comments as needed) *
Primary Reason for the Request (Providers may choose all that apply) *

Supporting Clinical Information
Be specific on what you want to send to Mayo for your consult. Tell us as much about the testing and data you want sent including; performing entities/locations, dates, and if you have the information in your office Electronic Health Record or if we need to get from the performing entity. Check the applicable boxes below and identify the patient medical information pertinent to the specific question being asked for.

We need your office to fax all results/reports from your EMR that you want sent to Mayo to:
Fax: 319-368-5581
Attention: E-consult Coordinator

Cardiac results