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Referrals/Forms

The Ohio State University Wexner Medical Center physicians represent virtually every specialty and subspecialty in medicine. Click on the following links for PDF forms and a PDF of our Service Referral Guide, which includes phone numbers for making patient appointments and a list of all the clinical services available, from anesthesia to wound healing.

Patient Referral Forms

Gastroenterology, Hepatology and Nutrition (154.6K)

Heart and Vascular MRI/CT Imaging Orders (460K)

Neurology (55.1K)

OSU Electrophysiology Program Referral – Patient Scheduling/Referral Form (55K)

OSU Heart and Vascular Center at Stoneridge (104.9K)

OSU Heart Center at Gahanna (33.4K)

OSU Heart Center at Martha Morehouse (30.8K)

Otolaryngology (71K)

Radiology (186.8K)

Rheumatology (66.5K)

Surgical Oncology (63.8K)

Vascular Diseases and Surgery (284.4K)


Other Forms

Ohio State's Medical Center Service Referral Guide (280K)

Tips for Transferring Patients (1MB)

Informed Consent Forms/Policies

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For services not listed or for additional information on a particular service, please call 800-293-5123, 8 a.m. to 5 p.m., Monday through Friday. The line is covered after hours, weekends, and holidays for urgent calls only, please.