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UW Health SMPH

How to Request an Outpatient Clinic Appointment

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(608) 263-8013
Information for Referring Physicians and Other Providers
 

UW Health offers services at more than 80 specialty clinics. To refer a patient for outpatient care, please use one of the following options*:

 

 

Fax FAX: Complete the Request for Clinic Appointment Form
This form can be used when referring a patient to any of the UW Health pediatric or adult specialty clinics. Please fax the form to (608) 203-2661 or toll-free at (888) 875-8490.

 

OnlineONLINE: Complete the Online Request for Appointment Form
This form can be used when referring a patient to any of the UW Health pediatric or adult specialty clinics.

 

 

PhonePHONE: Call the clinic directly. Directory (PDF)

 

* For URGENT referrals, please call the appropriate UW Health specialty clinic directly to schedule an appointment.

 

How the "Request for Clinic Appointment Form" Referral Process Works
 
To refer a patient via fax, please:
To refer a patient via the online form, please:
  • Complete the entire form.
  • Fax a copy of any pertinent clinical information, including lab and radiology results, to (608) 203-2661 or (888) 875-8490.
  • Inform the patient that we will contact him/her to schedule the appointment.
Once the form is received, it will be reviewed and processed. To confirm receipt of the form, you will receive one of the following:
  • An Appointment Status form. UW Health will contact the patient to arrange the appointment. A fax will be sent to you to notify you of the status of the appointment.
  • A Request for Additional Information form. If additional information is needed in order to schedule an appointment, a fax will be sent to you to request this information.
  • A phone call to request additional information or to communicate appointment information.