Telephone:

(540) 347-4200

(540) 341-7102 (fax)

Referrals

With the spread of “managed care”, many insurance plans require “referrals” from your primary care physician to see specialists or to get special tests performed.  Many plans will hold you financially responsible for services you receive without following their protocols, so it is important to familiarize yourself with your plan.  We have specially trained staff and protocols in place to help you obtain any necessary referrals.  If you require a referral, you may call us or fill out the electronic form below using the following protocol:

Please allow 2 business days for your referral request to be processed.  We will notify you when it is ready.

Please understand that if the information you leave by phone or electronically is incomplete, we will not be able to process the request.

Remember:  you may be financially responsible for referrals we give you in error based on inaccurate or outdated insurance information; thus, it is very important that you keep us updated on your current insurance coverage and any changes.

Patient's Name:

Please fill out the following information regarding the doctor you will be seeing:

Doctor's Name:

Address:

Telephone Number:

Date of the Appointment:

Reason for the Appointment:

Electronic Referral Form

Please complete the information below to request a referral.  Allow 2 business days for your referral request to be processed.  We will notify you when it is ready.

Telephone Number:

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Required Information