Referral Center

The Sanford Health Referral Center connects your patients to the right specialists for their needs. Refer a patient by phone at (844) 851-1515, fax or our online form below.

Records can be faxed to (605) 312-9806.

The Referral Process

1. A physician identifies patient needs.

2. Physician submits referral by phone, fax or online.

3. The referral center finds the appropriate specialist.

4. An electronic referral is sent. The specialty department contacts the patient.

Any information entered on this form is secure and protected according to HIPAA regulations.

Patient Information

Last Name*

First Name*

Middle Initial

Maiden Name / Alternate Name

Gender*

Date of Birth (MM/DD/YYYY)*

Primary Phone Number*

Alternate Phone Number

Address*

City*

State*

ZIP Code*

Insurance Provider*

Reason for Referral

Consultation

Medical Diagnosis*

Provider Signature*

Reason for Request*

Referring Provider Information

Last Name*

First Name*

Middle Initial

NPI

Phone Number*

Fax Number

Address*

City*

State*

ZIP Code*

Country

Email Address*

Patient's Primary Care Provider

Last Name

First Name

Middle Initial

Referral To

Specialty*

Provider Name (if known)

Referral Urgency*

Preferred Location

Our Doctors

Sanford Health News

background-image
Never too late for love for two Good Samaritan residents
Octogenarians Shirley Anderson and Henry Carey found each other at assisted living
background-image
Infant colds: What’s normal and what’s not
Learn the cold's causes, symptoms, how parents can help, and when to get care

View All News

Classes & Events

background-image
Breastfeeding Beginnings

Tue 12/30/25 6:30 PM - Tue 12/30/25 9:00 PM
Online
background-image
Grief Support Group

Thu 01/01/26 4:30 PM - Thu 01/01/26 6:00 PM
Sanford Bemidji Home Care & Hospice

View All Classes and Events

Referral Center

Referral Center

The Referral Process

Patient Information

Reason for Referral

Referring Provider Information

Patient's Primary Care Provider

Referral To

Sanford Health News

Never too late for love for two Good Samaritan residents

Infant colds: What’s normal and what’s not

Classes & Events

Breastfeeding Beginnings

Grief Support Group

expand menu button

expand menu button

expand menu button

expand menu button