New patient clinic referral
If you are being referred from an outside physician, the following, if applicable, will need to be sent from your doctor’s office before your first appointment. Please feel free to fill out the new patient information packet online, Patient Forms, or before your first appointment.
- Positive Cultures
- Radiology Report
- Office Notes
- Demographics
- Insurance
- PCP Referral
IV antibiotic referral
If you are being referred for IV antibiotics from an outside physician, the infusion/pharmacy referral form, will need to be filled out and faxed to
(817) 336-1643 or completed electronically by your doctor’s office.
Please also include:
- Last Chart Note
- Latest lab results
- Medication list
- Infusion/Pharmacy
Referral FormsFor Providers
- Clinic Referral
FormFor Providers