Cath Lab Scheduling Cath Lab Scheduling In order to process the appointment, please complete all of the information below. A coordinator will schedule an appointment as quickly as possible. Please ensure the accuracy of the information provided.Patient Name(Required) First Last Date of Birth(Required) MM slash DD slash YYYY Primary Phone(Required)Secondary PhoneRequesting Physician/Provider(Required) Physician Full Name Clinic Contact Name(Required) Full NamePhysician/Clinic Phone(Required)Authorization Number(Required) Insurance(Required) Insurance Policy Number(Required) Diagnosis Code(Required) ECHO Submitting this form will schedule an ECHO procedure for the patient.EmailThis field is for validation purposes and should be left unchanged.