MKTP Consult Request

Please be advised that this information is only used to determine your possible candidacy for the MKTP. Once your form is processed someone from the MKTP Team will be in contact with you within 7 - 10 days.

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Please call 911 if you have an emergency or urgent medical question.

Already a Henry Ford patient?
For the best experience, existing Henry Ford patients can request and self-schedule appointments through Henry Ford MyChart.

Henry Ford Health System is committed to ensuring our Deaf or hard-of-hearing patients and visitors have equal access to all services. We provide the appropriate auxiliary aids and services, including qualified sign language interpreters, TTYs and other assistive listening devices, at no cost. To request assistance, call 313-916-1896 or email [email protected].

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