Skip to main content

Refer a Patient to Urology Services

University of Utah Health's Urology Services is here to assist community physicians and specialists with consultation and referral services. To refer your patient, please fill out the information below and click on "Submit". You will receive a response within one business day. Please note that we can only respond to your request during normal business hours, 8am—5pm, Monday—Friday.

Referring Provider Information
Referring to Information
Urgency Rating:
Patient Information
Gender:
Address: