Guide for Physicians Referring to the Head & Neck Clinic (Wharton)

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​Standard Referral

To complete the standard referral process:

  1. Download and complete the appropriate referral form.
  2. Include the following documents:
    • Referral letter/consult note
    • Pathology reports
    • Surgical procedure notes
    • Diagnostic imaging reports
    • Clinical notes
  1. Fax the completed form to the fax number provided on the referral form.
  2. The form will be reviewed to ensure that it is complete; if incomplete, the form will be returned to you. On this page: Checklist for complete referral
  3. Our office will call you with information about the patient’s first appointment.
  4. Your office is responsible for providing the patient with the appointment information. This includes time and location, and important documents, test results and imaging that they must bring.

 

Checklist for a Complete Referral

To ensure your referral is complete, make sure to include:

  • A referral form, filled out in its entirety
  • Referral letter/consult note
  • Pathology reports
  • Surgical procedure notes
  • Diagnostic imaging reports
  • Clinical notes

If this information is not included with the referral form, your referral may be returned as incomplete.

Last reviewed: 7/14/2019
Last modified: 9/11/2019 6:58 AM