Make Consultation, Transport & Referral Requests
Referral/Consultation Request Form
To ensure continuity of care for the patient and to clarify if the request is for an opinion or transfer of care:
- Use the Referral/Consultation Request Form.
- Fax the form to the appropriate department when scheduling an appointment.
Cardiac CTA Referral Form
To refer a patient for a cardiac CTA, use the CCTA Physician Referral Forms below:
PET/CT Referral Form
To refer a patient for a PET/CT scan:
Pain Management Referral Form
To refer a patient for Pain Management:
- Use the Outpatient Pain Management Service Referral Form.
- Include a letter of referral with the patient.
PICU Consultation and Transport Criteria
If your patient meets the PICU consultation and transport criteria:
- Call Sanford Children's PICU at (800) 437-4010.
- Ask for the pediatric intensivist on call.
NICU Consultation and Transport
If you need to consult with or refer to Sanford Children's NICU:
Download the forms you need now.