Free Letter to Request a Referral to Another Doctor

This letter can be used to request a referral to a specialist for medical care.

Use the Letter to Request a Referral to Another Doctor document if:
  • You want to request a referral to a specialist when your insurance company or managed care organization requires a referral from your primary care physician.
  • You want to request a referral to a specialist when the specialist will not see you without a referral from your primary care physician.
  • You want to indicate which specialist you would like to see.
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