Refer a Patient
This page is for healthcare providers submitting a patient referral. If you’re looking to request an appointment for yourself, please visit our contact page.
Use the form below to submit a referral, or upload a completed referral document directly from your system. If you have a referral already generated, select the Upload a Referral tab and skip the form entirely. Either way, you can attach supporting documents or clinical notes to both.
You may also fax your referral to 217-607-1139
Questions? Call us at 217-352-0200.
