Refer a Patient

Referring Physician Resources

You can use Epic LINK to connect to our electronic medical record (EMR) system. Epic LINK allows you to do these things:

Refer patients
Track your patient's referral status
Review your patient's medical records

Contact our new patient coordinators for more information.

Patient Referral Form

Huntsman Cancer Institute (HCI) at University of Utah Health makes it easy for physicians to refer their patients. We also offer doctors consults with our specialists about treatment options and clinical trials.

Please answer the questions below. After you submit this information, one of our care coordinators will contact you within one business day.

Call us: 801-587-7000

Fax us: 801-213-6048

View a complete list of Huntsman Cancer Institute specialists by name or specialty

Does the patient have a cancer diagnosis? ^*

What type of cancer has been diagnosed?

Please share any health details that will help us get your patient the care they need ^*

Referring Physician’s Contact Information

First Name ^*

Last Name ^*

Practice/Organization Name

Phone Number ^*

Patient's Personal Information

First Name ^*

Last Name ^*

Gender

Male

Female

Date of Birth ^*

Phone Number ^*

Zip/Postal Code ^*