If you are a current patient of our practice, you can easily request referral forms online. Save time and take care of your request from the comfort of your home.
Simple and convenient
Step-by-step instructions How the referral request works
Who can request a referral online?
This service is only available to our existing patients. Referrals can only be issued for specialist fields that are part of your ongoing care. For new symptoms or medical assessments, please book an appointment with your doctor.
Your referral in a few steps:
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Fill out the form below with your name, date of birth, and the medical specialty.
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Indicate the reason for the referral (e.g., follow-up, diagnostic evaluation).
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Review your details and submit the form.
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Your referral will usually be ready for pickup at the practice within 1–2 business days.
Important Information about Referral Issuance
For patients with public health insurance, the electronic health card must be scanned in the current quarter before a referral can be issued.
Please note: Referrals cannot be mailed. You must pick them up in person or send someone with a signed authorization.
Your digital service Referral Request Form
Use this form to quickly and easily request a referral.
Important: Referrals can only be issued if your health insurance card has been presented for the current quarter.
Do you have any questions about the referral?
Contact our practice team - we will be happy to help you!