Now Taking Physician Referrals

Learn more about patient safety precautions, virtual visit options, and referring physician resources.

Thank you for referring your patient to University of Utah Health. We value our relationship with referring physicians. Please fill out the form below.

Fax applicable records to: 801-585-2388

Office hours: 8 am–5 pm

Referring Provider Information

Referring to Information

Patient Information

UCRM Andrology Services

We offer a full range of diagnostic tests for male infertility. We also have treatment options for patients who are trying to become pregnant, and for patients who are interested in cryopreservation for future fertility treatments.

UCRM Gynecology Services

We also offer a full range of testing for female infertility.

Submitting Requisition Orders

Our CAP (College of American Pathology) certification requires that we get an order from the patient’s referring provider. Please indicate the specific procedure for which you are referring your patient. Your staff can fill out our requisition order and requisition order for sperm preparation. You can also use a prescription pad or your own form.

Please include patient name, test(s) requested, a fax number (or address), and your signature. Your patient may bring the request in person or your staff may fax the requisition to 801-581-6127.


You will receive the test results with dictation five to seven days after your patient comes in for his appointment.

For your patient’s benefit, we also have available: