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Ways to Make Referrals


Download this form and please fill out completely:

Fax 336-252-2087



Email our referral coordinator. We check this email at least once per day. 


Online Form

A quick referral option that ensures you've given us the necessary information.



Call with the patient's information at hand:

Tel. 336-252-2085


Important Referral Notes: some insurances require that we obtain a consult note from the primary care provider. Notes also help ensure that we see the patient in the appropriate time frame, especially given that we are often booking months out. In order to provide timely appointments and maintain efficient clinical flow, we will wait until we have received notes before scheduling the patient for an examination. We will notify you of the date and time of appointment once made. Please call if ever you have questions or urgent needs.

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