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Refer a Patient

We welcome new patients. If you would like to refer your patient, please call our office at 205-638-9653.
For a listing of our clinics, please click here.
The referring physician’s office should fax (205-638-9972) the following information to us for an appointment.

  • New Patient Referral Form (PDF)
  • Demographics
  • Insurance. (If Medicaid or Tricare, please send referral) *Note*: All insurance should be up to date.
  • Clinic notes and growth charts 
  • Imaging reports.*Note*: We strive to not repeat imaging studies unnecessarily. Therefore, please insure that any outside imaging is placed on disk and that the patient/family brings the disk to the clinic appointment with the Neurosurgeon.
  • Cover sheet with your name, fax number and phone number. *Note*: We will fax you an appointment notification so that you can notify the parents about the appointment.

Once we receive the above information from the referring physician’s office, our office will fax an appointment notification letter back to them with the appointment details. The referring physician’s office will contact the patient’s family with the appointment information.

Thank you for referring your patient to us.