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Available Forms

COMMUNITY CLINICS-Specialty Request

Community Clinic Specialty Consult Request

 
The most important piece of information is the mobile phone number of the CLINICIAN responsible for the patient's care. lYou will receive an SMS reply (with no PHI included) from the specialty team clinical inbox.
 
 
 
 
 
While this is not a service for medically emergent conditions, even in the outpatient setting one might need a relatively prompt response. Please let us know how soon you need a reply from the specialist
 

Optional Information (if not relevant just click to submit form)

 
What is the next day you are working in the clinic and/or would reliably receive, view and respond to a secure message?
 

You will get a secure SMS message reply confirming receipt of this form. If you have supporting information such as a patient summary, recent reports or notes feel free to fax them to 240-408-7895 (arrives in our secure Updox inbox)

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