REFER A PATIENTThank you for referring your patient to us. If you prefer, you may call 800-888-5533 to refer patients via the UK-MD phone line.
Department-specific referral forms
If referring a patient to one of the areas below, complete and submit the department-specific form only. You do not need to complete the standard form.
If you are a patient, please use our appointment form.
-
Markey Cancer Center referral forms
- Clinical Genetic Counseling Referral Guidelines
- Clinical Genetic Counseling Referral Form (PDF, 95 KB)
- Molecular Tumor Board Referral - Learn more about the Molecular Tumor Board and submitting a patient's case.
- Precision Medicine Clinic Referral Form
- Hematology/BMT Referral Form (PDF, 71KB) - Refer your patients to Markey's Hematology and BMT Clinic using the attached form. Please fax completed forms to 859-323-5822.
-
Transplant referral forms
- Kidney/pancreas fax referral form (PDF, 113 KB)
- Vascular Access Consultation Request Form (PDF, 55 KB)
- Liver Transplant Consultation Request Form (PDF, 75 KB)
- Heart Transplant and Ventricular Assist Device Referral Checklist (PDF, 122 KB)
- Heart Transplant and Ventricular Assist Device Consultation Request Form (PDF, 60 KB)
- Lung Transplant Referral Form (PDF, 65 KB)