Cancer and Blood Diseases Institute

  • Physician Order and Referral / Consult Forms

    The staff at Cincinnati Children’s believes that building collaborative relationships with primary care physicians helps achieve the best outcomes when treating patients.

    One call to our Physician Priority Link hotline will tell you everything you need to know to refer a patient to Cincinnati Children’s. And, you can download any form you need right here.

    Referral / Consult Form Process

    Test and procedure referral forms are required by Cincinnati Children’s to schedule various procedures. These forms must be completed and faxed to the Cincinnati Children’s Scheduling Center as indicated on each form.

    Please fax all referrals and order forms (EXCEPT outpatient lab forms intended for walk-in procedures) to us at 513-803-1111 or toll free at 866-877-8905.

    Download Order and Referral / Consult Forms

    All referral / consult forms are provided in .pdf format.

    View and download referral forms.

 
 
 
 
  • Find Us

    Cincinnati Children's main campus is located at 3333 Burnet Avenue.

    Use our maps and driving directions to reach the right Cincinnati Children's location.

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