Referral Form

Referral Form for Kidney Care Clinic

At The Kidney Experts, we value the referrals that we receive from practices in our community. We have introduced a new referral process. Now referring practices do not have to wait on the phone for an appointment. Instead, they can fill out the referral form on this page to save valuable time.

Note: It is important to fill out all aspects of the referral form, including the requested lab values. This allows us to schedule patients for their kidney care appointment in a quick manner.

Patients with a GFR above 45 will be scheduled at the requested kidney care clinic. Patients with a GFR lower than 30 will be worked in the first available kidney care appointment slot.

After we receive a referral, our staff will get to work scheduling the appointment. Once scheduled, we will follow up with the referring clinic and the patient. We will provide appointment details and other items needed by our clinic. We will also mail an appointment reminder and a lab order form to the patient for follow-up labs.

If there are any questions throughout the process, please give us a call at 731-300-6155. Or send us a message through our Contact Us Page. Don’t forget to fax recent lab results and office visits after completion of the referral form. This helps us establish a new patient for the Kidney Care Clinic. Our fax number is 731-300-6955. New patients can view New Patient Information about their first visit.