UNC Department of Neurology Administrative Office: Physicians Office Building 170 Manning Drive, Campus Box 7025 Chapel Hill, NC 27599-7025 (919) 966-8178. Health Sciences Campus. Please submit the secure form below to refer your patient to a provider in the Neurology Department at Massachusetts General Hospital. For transplant referrals: Please fax Transplant Request Form, insurance information, and clinical records to 252-84-REFER (252-847-3337) Transplant Request Form. New Patient Referrals UNC Hospitals Adult Neurology Clinic (984) 974-4401. Additionally, we can coordinate with referring providers to furnish any follow-up they may need to treat the patient. The WVU Neurology team expands their services beyond the Morgantown campus each month, and provides care in a minimum of four . Discuss follow-up care regarding patients you have referred.
SECU Family House at UNC Hospitals, 123 Old Mason Farm Road, Chapel Hill, NC 27517 www.secufamilyhouse.org | 919 -932 8000 (phone) | 918 3830 (fax) FOR OFFICE USE: Referring physicians name. 3000 New Bern Ave. Raleigh, NC 27610; 919-350-8000; About Us; Careers; Commitment to Quality; News & Media; Notice of Privacy Practices Adult patients; Pediatric patients; Sleep Lab Referral Form. Referral Form Print and fill out this form, then fax it to REX Neurosurgery & Spine Specialists at (919) 784-1409 for a prompt patient referral. If you would like to make a referral to one of the VH Services and you do not need to talk to a VH clinician, you can use this form to submit the client and patient information. Please fax the completed form to the Duke Consultation and Referral Center at 919-479-2435. The UNC Sleep Lab is a referral-based clinic. At UNC REX, we understand the impact chronic pain can have on someone's life. Performs rooming and/or intake process, collecting and data, including vital signs, height, weight, and . If you would like information on how to gain access to UNC CareLink, please contact our physician relations department at uncrexphysicianrelations@unchealth.unc.edu. Department of Neurology.
If you have received a diagnosis from a primary care physician and wish to make an appointment for outpatient evaluation by a Duke neurologist, please contact our Neurology Appointment Center at 919-668-7600. Appointments 919-862-5620 Office 919-862-5620. UNC Health Care Panther Creek (Cary) (984) 215-6365. For use by physicians and their staff.
Please send radiographs or other images with the client or by submitting directly to us through eFilm (see instructions on main information for Referring Veterinarians page).. The Urgent Neurology Clinic's mandate is to see patients within five business days.
Diagnosis / reason for referral * * Name of UMMC Physician or specialty area you would like to contact you: * * Referring Physician Information: DO, MD, NP or PA * DO . Physician Referral Form : University of Minnesota Physicians Request for Consultation or Referral. we're offering Telehealth visits as another way to be seen by your provider.
1052 William Moore Dr. Raleigh, NC 27607. Thank you for sending your referral request to the NC State Veterinary Hospital Please send or fax supporting information. Do you think content or features on a UNC-Chapel Hill website are inaccessible to individuals with disabilities?. To refer a patient, complete and fax the Referral Form to 919-325-4680. A pediatrician is a primary care doctor with advanced training to care for the unique needs of babies, toddlers, children, adolescents, and young adults. To ensure an optimal first visit, our providers do require that the parent (s) or guardian be with their child. 8650 W. Tropicana Avenue, Ste.
Physician Referral Form * - Required Fields. Lake Norman Neurology welcomes new patients from ages 2 years through adult by appointment. Our multidisciplinary clinic includes neurologists, a movement disorders fellow, a physical therapist, a speech therapist, social workers, research coordinators, an occupational therapist and an HDSA volunteer. Address: 160 MacGregor Pines Drive, Suite 205, Cary, NC 27511. The Urgent Neurology Clinic is for people who have symptoms that are NEW and / or getting worse over days or weeks. Get Directions. type or clearly print. . 15-VH-293 6/23/20 . Please type or clearly print your information. Responsibilities: 1. Please send, along with the referral form above, office notes, MRIs done within the past 6 months, and a list of current medications. Physician's Full Name: Thank you for completing this form accurately, legibly, and completely!
Call (919) 445-2410. Contact Us. Department of Neurology. Consult. Our Financial Assistance Program helps relieve the financial burden of medically necessary healthcare services at participating UNC Health entities. Interventional radiology. Adult Neurology Referral Form. MRI Order Form. Referring Physician Information. Call (984) 974-4401 or email neurologyreferrals@unchealth.unc.edu. 984.974.2509. Pager No. 2002 marked the beginning of a new era. Thank you for referring your patient to UK HealthCare. Many of our patients are referred to us by their primary care providers, but a referral isn't always necessary. 3480 Wake Forest Rd. (Neurology). Find a Doctor; Primary Care & Specialties; Locations; Wait Times; About Us; News; One of our goals is to help minimize your pain and restore your . New Patient Referr al Form. In addition, we continue to offer phone call and face-to-face visits.
Physician Relations. Home / Locator / North Carolina / Greenville / Vidant Neurology - Greenville. Click here to download a PDF that describes how the referral process works.. Also see the Referral tab on the Urgent Neurology Clinic home page.. Jim Brawley, Hospital Administrator, 919.513.6687 or email jim_brawley@ncsu.edu. To schedule an appointment - or to learn more about the Pain Management Center at Rex Hospital in Raleigh, NC and how it can help you or someone you care about, call 984-215-6950. If you have any questions or would like hard copies delivered to your office, please call Jimmy Maher at (910) 615-4934. About the International Patient Center International Appointments & Referrals. Referral Forms. Referral Resources. Find Care Find Care . Email applications are preferred ( becky.edmondson@cidd.unc.edu ). Option 2: (Electronic Medical Record on hand): From the EMR, you may send signed physician orders with ALL supporting clinical documentation/records . The clinic also offers opportunities to participate in clinical trials. Phone: 702-871-1152 Fax: 702-262-7000 You can print out any of the forms by clicking on the name. Duke Medicine Plaza. Department of Neurology. Phone (appointments): 919-758-8677 Phone (general inquiries): 919-758-8677. Please provide a brief summary of the patient's problem and send supporting documents (lab results, chart notes) via e-mail ( ncstatevetbehavior@ncsu.edu) or fax (919-513-6905). Name and Title of Staff Completing this Form Phone No. Radiology / imaging requests and referrals. The division is a leader in diagnosing and managing . Please be sure to have your insurance information and referring physician name, address, and phone . Our Team; Epilepsy Neurogenetics Initiative. If so, please use this form to let the Digital Accessibility Office know about your concerns. Direct Message: Referral@Direct.VidantHealth.com. After you submit this form, you will receive a phone response within 24 .
PATIENT INFORMATION. Clinic address. If your referral is accepted, we will do everything we can to see you within 5 business days. Calling the office at 919-782-3456 with any questions regarding the referral process. Please arrive at least 20 minutes before your appointment in order to get registered. The Department's state-of-the-art neuro-ophthalmology care helps thousands of patients restore or improve vision. If you are a Provider referring a patient, please select the appropriate service offering below. Refer a patient online or access patient records: unccarelink.org. Vidant Neurology - Greenville . NC Cancer Hospital A complete Clinician Order Form should be filled out and . Patients who suffer from headaches, back and neck problems, seizures, memory loss, and other brain disorders may seek the assistance of a neurologist. UNC Child Neurology Referral Form . In those cases, please call us at 855-644-6387. Appointments with Duke Neurology. This video highlights the great work being done at the UNC Kidney Center, and features several faculty, staff, and patients. Physicians in Wilmington Health Neurology diagnose and treat disorders of the central and peripheral nervous systems, which include the brain, spinal cord, and nerves in the body. Magnetic resonance imaging (MRI) - Uses radio waves and a magnetic field to make images of the inside of the body. To schedule an appointment, call 919-681-0707. Providers
After we see the client and patient in our office, we will send to you a detailed referral summary.
Our unified and dynamic hospital system is . Please call (984) 974-7337 if you have any questions. Please call our office if you have specific questions or would like to schedule an appointment. Mon.
Patients come to the Department of Neurology at Ohio State Wexner Medical Center for treatments and services they cannot find elsewhere.
Call Vidant Neurology - Greenville, located at 9 Medical Drive in Greenville to schedule an appointment.
Patients must be referred through their primary care provider or specialist. Assist in obtaining follow-up information on patients recently seen at Duke. United Hospital Center 327 Medical Park Drive Bridgeport, WV 26330 681-342-1000 Referral Resources. Child Neurology Referral Form. Please arrive at least 20 minutes before your appointment in order to get registered. Refer a patient online or access patient records: unccarelink.org. Application deadline is January 9, 2015. This is critical to obtaining accurate history and information which allows our providers . . Questions? At UNC Health, you'll find hospitals, clinics, and locations throughout North Carolina all focused on the same mission: To improve and support the health and well-being of North Carolinians and all those we serve. Submit a referrals through UNC CareLink or fax a referral form to (984) 974-9786.
Raleigh, NC 27609-7376. The following external links provide information on what to expect and how to prepare for various diagnostic tests used in neurology. Faxing the Dev Peds Referral Form to 919-788-8986. Magnetic resonance imaging (MRI) - Uses radio waves and a magnetic field to make images of the inside of the body. MKT-1134 4/2017 Duke Health To submit a referral request. The Duke Neuro-Ophthalmology Division is led by prominent physicians who are internationally recognized for their contributions to advancing patient care. Interventional radiology. We do request any background and pertinent office notes to help us provide high-quality service to the patient. UNC Hospitals Neurosurgery NEW PATIENT REFERRAL FORM. Physician Referral Form * - Required Fields. Contact Us. UPIN. For more information, please contact the Physician Liaison Program at 859-323-0736. Contact Us. If you have questions about your referral or if this is an urgent request, please call 800-MED-DUKE (633-3853). We offer comprehensive consultation, evaluation and treatment services for adults and children with neurological disorders. Medical Office Building. Access Form.
919.513.6500 . needs to be seen within 24hrs), please call the . Computed tomography (CT) - Creates detailed, cross-sectional pictures of the inside of the body. Calling the office at 919-782-3456 with any questions regarding the referral process.
If you need sleep services, please have your primary care physician contact our referral service to schedule an appointment: . * * * * * * Alternate Phone . Below is a list of all the referral forms for Cape Fear Valley Health System. Neurosurgery Referrals: UNC CareLink.
Address: 160 MacGregor Pines Drive, Suite 205, Cary, NC 27511.
Please send, along with the referral form above, office notes, MRIs done within the past 6 months, and a list of current medications. Please call our office at 828-255-7776 to schedule.
Child Neurology. . Please fax the completed form to the Duke Consultation and Referral Center at 919-479-2435. Read more. Option 1: (no Electronic Medical Record) fill out all information on this PDF form, then submit the completed form via email or via fax to 720.848.1651. Patient Information: First Name * * Middle Name: Last Name * * Date of Birth * * Phone Number * - ext. Further investigations are then expedited as needed. Direct Message: Referral@Direct.VidantHealth.com. B-107, Las Vegas, NV 89147. Our Team; Research; Patient Resources . UNC CareLink. Divisions. * * * * * * Alternate Phone . AUNC Pediatric Patient Medical History Form PDF (Click to Download) Patient Health Information (Click to Download) Associated Urologists of North Carolina, Cary, NC. Explore the UNC Health system, which includes UNC Hospitals, a provider network, clinical programs, and affiliate hospitals . If you don't have a UNC CareLink account, please fax a completed referral form, including a specific referral question and records to (984) 974-5437. Diagnosis / reason for referral * * Name of UMMC Physician or specialty area you would like to contact you: * * Referring Physician Information: DO, MD, NP or PA * DO .
NC . For more than half a century, the Department of Pediatrics at the University of North Carolina School of Medicine has offered excellent, cutting-edge care in our children's units at UNC Hospitals. Do you have comments or suggestions to improve the digital accessibility of a UNC-Chapel Hill website or online tool?. ECU Health. Referral Form Print and fill out this form, then fax it to REX Neurosurgery & Spine Specialists at (919) 784-1409 for a prompt patient referral. Breast imaging, including 3D mammograms - Screens for signs of or diagnoses breast cancer. Date of Request: _____ This form is a fillable PDF. MKT-1134 4/2017 Duke Health Private Referral Practice, Denver, CO. Christine Thompson, BVMS, PhD,Diplomate ACVIM (Neurology). Computed tomography (CT) - Creates detailed, cross-sectional pictures of the inside of the body. Phone (appointments): 919-758-8677 Phone (general inquiries): 919-758-8677. If this is an EMERGENCY REFERRAL (i.e. Call (910) 715-8700 or (855) 535-8700 toll free to schedule a visit. If you would like to speak to a clinician about a behavioral . Call 513-475-UCMD (8263) or 1-877-475-UCMD (8263) to: Connect to a UC Health physician in any specialty for a telephone consultation (informational or referral) within 3 minutes. Facilitate patient appointments. Breast imaging, including 3D mammograms - Screens for signs of or diagnoses breast cancer. Patients must be referred through their primary care provider or specialist.
The WVU Neurology team expands their services beyond the Morgantown campus each month, and provides care in a minimum of four . Option 2: (Electronic Medical Record on hand): From the EMR, you may send signed physician orders with ALL supporting clinical documentation/records . The neurology residency program at North Carolina State University is a three-year program designed to provide advanced training in both medical and surgical neurology. If you are a patient, please use our appointment form. Clinic physicians are board-certified in anesthesiology, neurology and pain management, placing them in the unique position to provide diagnosis and treatment for any source of pain, from degenerative diseases to migraines. UNC Health Care Panther Creek (Cary) (984) 215-6365. UNC welcomed Jai Radhakrishnan, MD, professor of medicine and director of nephrology clinical services at Columbia University Medical Center to speak at its annual GDCN meeting on May 4, 2019. your information. Faxing the Referral Form to 919-420-1686; Calling the office at 919-782-3456 with any questions regarding the referral . New Patient Referrals UNC Hospitals Adult Neurology Clinic (984) 974-4401. To schedule an appointment with our Neurology and Neurosurgery department, ask for a referral from your primary veterinarian. Facilitate patient scheduling matters. Pain Management. The program is available to North Carolina residents with a household income at or below 250% of the Federal Poverty Guideline for your family size. Call 1-800-MED-DUKE (800-633-3853) The Duke Consultation and Referral Center can: Put you in touch with a specific physician or service. Fax Office 919-862-5611 Referrals 919-668-0374. If you have questions about your referral or if this is an urgent request, please call 800-MED-DUKE (633-3853). Wilmington Health 1202 Medical Center Drive Wilmington, NC 28401 910-341-3300. Clinic city. To submit a referral request. Please fax back referral form and all pertinent records to (984) 974-6741. Referring office Referring office phone Office contact Contact's fax UNC CareLink. If you have a . UNC CareLink. Please provide a summary of the history of the case so . Date of Request: _____ This form is a fillable PDF. For the first time, all pediatric services were provided out of a single state-of-the-art facility, NC . 706-721-4581. Referrals. Have you been referred to the Urgent Neurology Clinic by a physician? Our offices are located in Pinehurst at 10 Aviemore Drive and Sanford at 2910 Beechtree Drive. Faxing the Peds Neurology Referral Form to 919-788-8986. Providers Appointment. Clinic name. Cancer Treatment & CyberKnife Center
.
Closed. If this is an EMERGENCY REFERRAL (i.e. The Department of Neurology provides comprehensive, interdisciplinary care for stroke, movement disorders, headaches, epilepsy, multiple sclerosis, cancer, and neurodegenerative conditions such as Alzheimer's disease. PhysicianRelations@unchealth.unc.edu. Radiology / imaging requests and referrals. PhysicianRelations@unchealth.unc.edu. This form should not be used for appointments needed within 72 hours. Consult or referral? Am I Eligible for Financial Assistance? Our physicians diagnose and treat a wide range of rare and common neurological diseases. At a convenient UNC Health office near you in North Carolina, your child's highly qualified pediatrician provides: Annual checkups to monitor your child's physical, mental, emotional, and . 706-721-1459. Summary: The Practice Manager II is responsible for the management of 2 physician practice locations and/or with (combined) 6 - 10 providers. Please fill out as much of this form as possible to facilitate the consultative p rocess Please note that we do not offer consultative services for concussion, learning difficulties, behavior problems, ADHD, POTS, PANDAS or autism (except if there is a concern about comorbid epilepsy). This is the place. Select an appropriate Duke physician based on your patients' diagnosis.
Option 1: (no Electronic Medical Record) fill out all information on this PDF form, then submit the completed form via email or via fax to 720.848.1651. .
The Medical Assistant I, Certified works under the clinical supervision of the provider for patient care activities, and under the general direction of the designated manager/supervisor for non-clinical responsibilities.
Provider Login. Fax No. Ways to refer include: Submitting an electronic referral via the Infina Network.
Refer a patient to Neurosurgery. Referrals are received and looked at everyday, except weekends. needs to be seen within 24hrs), please call the appropriate service immediately after submitting the information below. Physician Relations. Refer a patient to Neurosurgery. . To apply, please send a letter detailing professional interests and goals, CV, and three letters of recommendation to Dr. Rebecca Edmondson Pretzel, CIDD, UNC-CH, CB# 7255, Chapel Hill, NC 27599-7255. Thank you very much for your understanding and please check back here for any updates. We focus on finding the causes of disease and injury, their progression, treatment and prevention. The Urgent Neurology Clinic was established in 2000 so adult patients requiring an urgent outpatient neurological consultation could be seen in a timely manner. 984.974.2509. Access resources for UNC Health medical professionals and for referring providers. We focus on finding the causes of disease and injury, their progression, treatment and prevention.
SECU Family House at UNC Hospitals, 123 Old Mason Farm Road, Chapel Hill, NC 27517 www.secufamilyhouse.org | 919 -932 8000 (phone) | 918 3830 (fax) FOR OFFICE USE: Referring physicians name. 3000 New Bern Ave. Raleigh, NC 27610; 919-350-8000; About Us; Careers; Commitment to Quality; News & Media; Notice of Privacy Practices Adult patients; Pediatric patients; Sleep Lab Referral Form. Referral Form Print and fill out this form, then fax it to REX Neurosurgery & Spine Specialists at (919) 784-1409 for a prompt patient referral. If you would like to make a referral to one of the VH Services and you do not need to talk to a VH clinician, you can use this form to submit the client and patient information. Please fax the completed form to the Duke Consultation and Referral Center at 919-479-2435. The UNC Sleep Lab is a referral-based clinic. At UNC REX, we understand the impact chronic pain can have on someone's life. Performs rooming and/or intake process, collecting and data, including vital signs, height, weight, and . If you would like information on how to gain access to UNC CareLink, please contact our physician relations department at uncrexphysicianrelations@unchealth.unc.edu. Department of Neurology.
If you have received a diagnosis from a primary care physician and wish to make an appointment for outpatient evaluation by a Duke neurologist, please contact our Neurology Appointment Center at 919-668-7600. Appointments 919-862-5620 Office 919-862-5620. UNC Health Care Panther Creek (Cary) (984) 215-6365. For use by physicians and their staff.
Please send radiographs or other images with the client or by submitting directly to us through eFilm (see instructions on main information for Referring Veterinarians page).. The Urgent Neurology Clinic's mandate is to see patients within five business days.
Diagnosis / reason for referral * * Name of UMMC Physician or specialty area you would like to contact you: * * Referring Physician Information: DO, MD, NP or PA * DO . Physician Referral Form : University of Minnesota Physicians Request for Consultation or Referral. we're offering Telehealth visits as another way to be seen by your provider.
1052 William Moore Dr. Raleigh, NC 27607. Thank you for sending your referral request to the NC State Veterinary Hospital Please send or fax supporting information. Do you think content or features on a UNC-Chapel Hill website are inaccessible to individuals with disabilities?. To refer a patient, complete and fax the Referral Form to 919-325-4680. A pediatrician is a primary care doctor with advanced training to care for the unique needs of babies, toddlers, children, adolescents, and young adults. To ensure an optimal first visit, our providers do require that the parent (s) or guardian be with their child. 8650 W. Tropicana Avenue, Ste.
Physician Referral Form * - Required Fields. Lake Norman Neurology welcomes new patients from ages 2 years through adult by appointment. Our multidisciplinary clinic includes neurologists, a movement disorders fellow, a physical therapist, a speech therapist, social workers, research coordinators, an occupational therapist and an HDSA volunteer. Address: 160 MacGregor Pines Drive, Suite 205, Cary, NC 27511. The Urgent Neurology Clinic is for people who have symptoms that are NEW and / or getting worse over days or weeks. Get Directions. type or clearly print. . 15-VH-293 6/23/20 . Please type or clearly print your information. Responsibilities: 1. Please send, along with the referral form above, office notes, MRIs done within the past 6 months, and a list of current medications. Physician's Full Name: Thank you for completing this form accurately, legibly, and completely!
Call (919) 445-2410. Contact Us. Department of Neurology. Consult. Our Financial Assistance Program helps relieve the financial burden of medically necessary healthcare services at participating UNC Health entities. Interventional radiology. Adult Neurology Referral Form. MRI Order Form. Referring Physician Information. Call (984) 974-4401 or email neurologyreferrals@unchealth.unc.edu. 984.974.2509. Pager No. 2002 marked the beginning of a new era. Thank you for referring your patient to UK HealthCare. Many of our patients are referred to us by their primary care providers, but a referral isn't always necessary. 3480 Wake Forest Rd. (Neurology). Find a Doctor; Primary Care & Specialties; Locations; Wait Times; About Us; News; One of our goals is to help minimize your pain and restore your . New Patient Referr al Form. In addition, we continue to offer phone call and face-to-face visits.
Physician Relations. Home / Locator / North Carolina / Greenville / Vidant Neurology - Greenville. Click here to download a PDF that describes how the referral process works.. Also see the Referral tab on the Urgent Neurology Clinic home page.. Jim Brawley, Hospital Administrator, 919.513.6687 or email jim_brawley@ncsu.edu. To schedule an appointment - or to learn more about the Pain Management Center at Rex Hospital in Raleigh, NC and how it can help you or someone you care about, call 984-215-6950. If you have any questions or would like hard copies delivered to your office, please call Jimmy Maher at (910) 615-4934. About the International Patient Center International Appointments & Referrals. Referral Forms. Referral Resources. Find Care Find Care . Email applications are preferred ( becky.edmondson@cidd.unc.edu ). Option 2: (Electronic Medical Record on hand): From the EMR, you may send signed physician orders with ALL supporting clinical documentation/records . The clinic also offers opportunities to participate in clinical trials. Phone: 702-871-1152 Fax: 702-262-7000 You can print out any of the forms by clicking on the name. Duke Medicine Plaza. Department of Neurology. Phone (appointments): 919-758-8677 Phone (general inquiries): 919-758-8677. Please provide a brief summary of the patient's problem and send supporting documents (lab results, chart notes) via e-mail ( ncstatevetbehavior@ncsu.edu) or fax (919-513-6905). Name and Title of Staff Completing this Form Phone No. Radiology / imaging requests and referrals. The division is a leader in diagnosing and managing . Please be sure to have your insurance information and referring physician name, address, and phone . Our Team; Epilepsy Neurogenetics Initiative. If so, please use this form to let the Digital Accessibility Office know about your concerns. Direct Message: Referral@Direct.VidantHealth.com. After you submit this form, you will receive a phone response within 24 .
PATIENT INFORMATION. Clinic address. If your referral is accepted, we will do everything we can to see you within 5 business days. Calling the office at 919-782-3456 with any questions regarding the referral process. Please arrive at least 20 minutes before your appointment in order to get registered. The Department's state-of-the-art neuro-ophthalmology care helps thousands of patients restore or improve vision. If you are a Provider referring a patient, please select the appropriate service offering below. Refer a patient online or access patient records: unccarelink.org. Vidant Neurology - Greenville . NC Cancer Hospital A complete Clinician Order Form should be filled out and . Patients who suffer from headaches, back and neck problems, seizures, memory loss, and other brain disorders may seek the assistance of a neurologist. UNC Child Neurology Referral Form . In those cases, please call us at 855-644-6387. Appointments with Duke Neurology. This video highlights the great work being done at the UNC Kidney Center, and features several faculty, staff, and patients. Physicians in Wilmington Health Neurology diagnose and treat disorders of the central and peripheral nervous systems, which include the brain, spinal cord, and nerves in the body. Magnetic resonance imaging (MRI) - Uses radio waves and a magnetic field to make images of the inside of the body. To schedule an appointment, call 919-681-0707. Providers
After we see the client and patient in our office, we will send to you a detailed referral summary.
Our unified and dynamic hospital system is . Please call (984) 974-7337 if you have any questions. Please call our office if you have specific questions or would like to schedule an appointment. Mon.
Patients come to the Department of Neurology at Ohio State Wexner Medical Center for treatments and services they cannot find elsewhere.
Call Vidant Neurology - Greenville, located at 9 Medical Drive in Greenville to schedule an appointment.
Patients must be referred through their primary care provider or specialist. Assist in obtaining follow-up information on patients recently seen at Duke. United Hospital Center 327 Medical Park Drive Bridgeport, WV 26330 681-342-1000 Referral Resources. Child Neurology Referral Form. Please arrive at least 20 minutes before your appointment in order to get registered. Refer a patient online or access patient records: unccarelink.org. Application deadline is January 9, 2015. This is critical to obtaining accurate history and information which allows our providers . . Questions? At UNC Health, you'll find hospitals, clinics, and locations throughout North Carolina all focused on the same mission: To improve and support the health and well-being of North Carolinians and all those we serve. Submit a referrals through UNC CareLink or fax a referral form to (984) 974-9786.
Raleigh, NC 27609-7376. The following external links provide information on what to expect and how to prepare for various diagnostic tests used in neurology. Faxing the Dev Peds Referral Form to 919-788-8986. Magnetic resonance imaging (MRI) - Uses radio waves and a magnetic field to make images of the inside of the body. MKT-1134 4/2017 Duke Health To submit a referral request. The Duke Neuro-Ophthalmology Division is led by prominent physicians who are internationally recognized for their contributions to advancing patient care. Interventional radiology. We do request any background and pertinent office notes to help us provide high-quality service to the patient. UNC Hospitals Neurosurgery NEW PATIENT REFERRAL FORM. Physician Referral Form * - Required Fields. Contact Us. UPIN. For more information, please contact the Physician Liaison Program at 859-323-0736. Contact Us. If you have questions about your referral or if this is an urgent request, please call 800-MED-DUKE (633-3853). We offer comprehensive consultation, evaluation and treatment services for adults and children with neurological disorders. Medical Office Building. Access Form.
919.513.6500 . needs to be seen within 24hrs), please call the . Computed tomography (CT) - Creates detailed, cross-sectional pictures of the inside of the body. Calling the office at 919-782-3456 with any questions regarding the referral process.
If you need sleep services, please have your primary care physician contact our referral service to schedule an appointment: . * * * * * * Alternate Phone . Below is a list of all the referral forms for Cape Fear Valley Health System. Neurosurgery Referrals: UNC CareLink.
Address: 160 MacGregor Pines Drive, Suite 205, Cary, NC 27511.
Please send, along with the referral form above, office notes, MRIs done within the past 6 months, and a list of current medications. Please call our office at 828-255-7776 to schedule.
Child Neurology. . Please fax the completed form to the Duke Consultation and Referral Center at 919-479-2435. Read more. Option 1: (no Electronic Medical Record) fill out all information on this PDF form, then submit the completed form via email or via fax to 720.848.1651. Patient Information: First Name * * Middle Name: Last Name * * Date of Birth * * Phone Number * - ext. Further investigations are then expedited as needed. Direct Message: Referral@Direct.VidantHealth.com. B-107, Las Vegas, NV 89147. Our Team; Research; Patient Resources . UNC CareLink. Divisions. * * * * * * Alternate Phone . AUNC Pediatric Patient Medical History Form PDF (Click to Download) Patient Health Information (Click to Download) Associated Urologists of North Carolina, Cary, NC. Explore the UNC Health system, which includes UNC Hospitals, a provider network, clinical programs, and affiliate hospitals . If you don't have a UNC CareLink account, please fax a completed referral form, including a specific referral question and records to (984) 974-5437. Diagnosis / reason for referral * * Name of UMMC Physician or specialty area you would like to contact you: * * Referring Physician Information: DO, MD, NP or PA * DO .
NC . For more than half a century, the Department of Pediatrics at the University of North Carolina School of Medicine has offered excellent, cutting-edge care in our children's units at UNC Hospitals. Do you have comments or suggestions to improve the digital accessibility of a UNC-Chapel Hill website or online tool?. ECU Health. Referral Form Print and fill out this form, then fax it to REX Neurosurgery & Spine Specialists at (919) 784-1409 for a prompt patient referral. Breast imaging, including 3D mammograms - Screens for signs of or diagnoses breast cancer. Date of Request: _____ This form is a fillable PDF. MKT-1134 4/2017 Duke Health Private Referral Practice, Denver, CO. Christine Thompson, BVMS, PhD,Diplomate ACVIM (Neurology). Computed tomography (CT) - Creates detailed, cross-sectional pictures of the inside of the body. Phone (appointments): 919-758-8677 Phone (general inquiries): 919-758-8677. If this is an EMERGENCY REFERRAL (i.e. Call (910) 715-8700 or (855) 535-8700 toll free to schedule a visit. If you would like to speak to a clinician about a behavioral . Call 513-475-UCMD (8263) or 1-877-475-UCMD (8263) to: Connect to a UC Health physician in any specialty for a telephone consultation (informational or referral) within 3 minutes. Facilitate patient appointments. Breast imaging, including 3D mammograms - Screens for signs of or diagnoses breast cancer. Patients must be referred through their primary care provider or specialist.
The WVU Neurology team expands their services beyond the Morgantown campus each month, and provides care in a minimum of four . Option 2: (Electronic Medical Record on hand): From the EMR, you may send signed physician orders with ALL supporting clinical documentation/records . The neurology residency program at North Carolina State University is a three-year program designed to provide advanced training in both medical and surgical neurology. If you are a patient, please use our appointment form. Clinic physicians are board-certified in anesthesiology, neurology and pain management, placing them in the unique position to provide diagnosis and treatment for any source of pain, from degenerative diseases to migraines. UNC Health Care Panther Creek (Cary) (984) 215-6365. UNC welcomed Jai Radhakrishnan, MD, professor of medicine and director of nephrology clinical services at Columbia University Medical Center to speak at its annual GDCN meeting on May 4, 2019. your information. Faxing the Referral Form to 919-420-1686; Calling the office at 919-782-3456 with any questions regarding the referral . New Patient Referrals UNC Hospitals Adult Neurology Clinic (984) 974-4401. To schedule an appointment with our Neurology and Neurosurgery department, ask for a referral from your primary veterinarian. Facilitate patient scheduling matters. Pain Management. The program is available to North Carolina residents with a household income at or below 250% of the Federal Poverty Guideline for your family size. Call 1-800-MED-DUKE (800-633-3853) The Duke Consultation and Referral Center can: Put you in touch with a specific physician or service. Fax Office 919-862-5611 Referrals 919-668-0374. If you have questions about your referral or if this is an urgent request, please call 800-MED-DUKE (633-3853). Wilmington Health 1202 Medical Center Drive Wilmington, NC 28401 910-341-3300. Clinic city. To submit a referral request. Please fax back referral form and all pertinent records to (984) 974-6741. Referring office Referring office phone Office contact Contact's fax UNC CareLink. If you have a . UNC CareLink. Please provide a summary of the history of the case so . Date of Request: _____ This form is a fillable PDF. For the first time, all pediatric services were provided out of a single state-of-the-art facility, NC . 706-721-4581. Referrals. Have you been referred to the Urgent Neurology Clinic by a physician? Our offices are located in Pinehurst at 10 Aviemore Drive and Sanford at 2910 Beechtree Drive. Faxing the Peds Neurology Referral Form to 919-788-8986. Providers Appointment. Clinic name. Cancer Treatment & CyberKnife Center
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Closed. If this is an EMERGENCY REFERRAL (i.e. The Department of Neurology provides comprehensive, interdisciplinary care for stroke, movement disorders, headaches, epilepsy, multiple sclerosis, cancer, and neurodegenerative conditions such as Alzheimer's disease. PhysicianRelations@unchealth.unc.edu. Radiology / imaging requests and referrals. PhysicianRelations@unchealth.unc.edu. This form should not be used for appointments needed within 72 hours. Consult or referral? Am I Eligible for Financial Assistance? Our physicians diagnose and treat a wide range of rare and common neurological diseases. At a convenient UNC Health office near you in North Carolina, your child's highly qualified pediatrician provides: Annual checkups to monitor your child's physical, mental, emotional, and . 706-721-1459. Summary: The Practice Manager II is responsible for the management of 2 physician practice locations and/or with (combined) 6 - 10 providers. Please fill out as much of this form as possible to facilitate the consultative p rocess Please note that we do not offer consultative services for concussion, learning difficulties, behavior problems, ADHD, POTS, PANDAS or autism (except if there is a concern about comorbid epilepsy). This is the place. Select an appropriate Duke physician based on your patients' diagnosis.
Option 1: (no Electronic Medical Record) fill out all information on this PDF form, then submit the completed form via email or via fax to 720.848.1651. .
The Medical Assistant I, Certified works under the clinical supervision of the provider for patient care activities, and under the general direction of the designated manager/supervisor for non-clinical responsibilities.
Provider Login. Fax No. Ways to refer include: Submitting an electronic referral via the Infina Network.
Refer a patient to Neurosurgery. Referrals are received and looked at everyday, except weekends. needs to be seen within 24hrs), please call the appropriate service immediately after submitting the information below. Physician Relations. Refer a patient to Neurosurgery. . To apply, please send a letter detailing professional interests and goals, CV, and three letters of recommendation to Dr. Rebecca Edmondson Pretzel, CIDD, UNC-CH, CB# 7255, Chapel Hill, NC 27599-7255. Thank you very much for your understanding and please check back here for any updates. We focus on finding the causes of disease and injury, their progression, treatment and prevention. The Urgent Neurology Clinic was established in 2000 so adult patients requiring an urgent outpatient neurological consultation could be seen in a timely manner. 984.974.2509. Access resources for UNC Health medical professionals and for referring providers. We focus on finding the causes of disease and injury, their progression, treatment and prevention.