Clinic Support Website

Make Continuity Appointment

• Internal Medicine Appointment Request Form

Make Enhanced Care Appointment

• Enhanced Care Appointment Request Form
  (includes appointment requests to Diabetes, Anticoag, Pain (click for details on making a pain referral), and Nutrition)
• Diabetes Self-Management Class Referral Form

Labs

• Phlebotomy Request Form
• Add-on Lab Request Form
• Weekend Phlebotomy (fax to 843-3731; call 843-1760 before faxing)

Nurse Assistance

• Nurse Assistance Request Form (please call patient)

Referrals

• Specialty Clinics Referral Form

Ancillaries

• Cardiac Procedures
• CT Scan
• Echo
• GI Procedures
• Mammography
• MRI / MRA
• Neurophysiology Procedures
• Nuclear Medicine / PET
• Peripheral Vascular Lab
• Pulmonary Function
• X-Ray

Continuity Clinic Schedule Changes (for faculty provider use only; housestaff must go through chiefs)

• Request Form for Continuity Clinic Schedule Changes (includes requests for block, unblock, freeze, or add)

Enhanced Care Schedule Changes (for mid-level provider use only)

• Request Form for Enhanced Care Schedule Changes (includes requests for block, unblock, freeze, or add)