How to Refer Your Patient

We accept referrals over the phone 801-581-6795. 

Patient Information Needed

The following information, if available, will be requested at the time of referral:

  • Patient demographics, including current insurance information
  • Two years of medical records from all attending physicians and specialists
  • History and physical
  • Lab work
  • Radiology reports
  • Pathology report, including liver biopsy if available
  • Surgery and procedure reports, including EGD, Colonoscopy, pap smear, and mammogram, if applicable
  • If there is a history of drug or alcohol abuse, the patient will need to provide documentation of six months of attendance in a relapse prevention program, such as alcoholics anonymous, or private inpatient or outpatient treatment and results of six months of random drug and alcohol screens from referring physicians.
  • Immunization records
  • A letter from your dentist stating that all dental work has been completed and that no further dental treatment, other than teeth cleaning, should be required for one year.