Referral Form for Physicians
Thank you for referring your patient to UK HealthCare. Please fill out and
submit the secure form below to begin the referral process.
After you submit this form, you will receive a phone response within 24 hours,
excluding weekends and holidays.
You may also refer patients by phone by calling UK-MDs at 859-257-5522 or 1-800-888-5533 or by printing and faxing this form to 859-323-6325.
PATIENT MAILING ADDRESS
REFERRAL PROVIDER INFORMATION
OFFICE MAILING ADDRESS
All e-mail referral forms will receive a phone response within 24 hours hours
excluding weekends and holidays. If you do not receive a response in 24 hours,
please call us at (800) 888-5533 or in Lexington (859) 231-9922.
UK-MDs respects the confidentiality of your personal
information and promises only to use it for internal purposes as it relates to
this request. By submitting this form, you will transmit your details to us
safely over a 128-bit encrypted secure network.