PHYSICIAN REFERRALS
Gem City Hand and Microsurgeons partners with primary care physicians, urgent care providers, emergency medicine specialists, and other referring clinicians throughout the Greater Dayton area to provide expert surgical care for conditions of the hand, wrist, and upper extremity. Our referral process is designed to be straightforward for your office staff, so your patients can get to the right specialist without unnecessary delays.
How to Submit a Referral
To refer a patient to our practice, please download and complete the referral form below and submit it to our team using one of the following methods:
Fax: (937) 704-2140
Email: [INSERT DEDICATED REFERRAL EMAIL — PENDING]
Once we receive your referral, a member of our team will contact the patient directly to schedule their appointment. For urgent referrals, please indicate that clearly on the form and call our office directly at (937) 704-2130 so we can prioritize scheduling.
What to Include
To help us prepare for your patient's visit, please complete all required fields on the referral form, including the reason for referral, relevant insurance information, and your preferred provider if applicable.
DISCLAIMER: This form is for use by medical providers only and is not intended for patient self-referrals.