How to Refer a Patient

You can refer a patient by completing and faxing this form to (304) 925-8953.

New Patient Referral Form

Items to Provide with Your Referral

When referring a patient please include relative to the referral, such as:

  • Pathology reports
  • Lab reports
  • X-ray and scan reports
  • History and Physical
  • Office notes
  • Operative reports
  • Copy of your patient’s insurance card, front and back