Division of Urologic Surgery - UNC School of Medicine
Document Actions
Referrals Peds
Referring physicians can refer patients by contacting Tryston Jack at 919-966-2573.
Required Patient Information
- Patient's full name
- Address
- Phone number(s)
- Date of birth
- Social security number
- Diagnosis or explanation of the current medical problem
- Insurance coverage
- Scheduling preferences
Required Referring Physician Information
- Name
- Address
- Phone number
- Specialty
- Pertinent medical records detailing patient's medical history and diagnosis, faxed to 919-966-0098.
A consultation with a Urologist can be arranged by contact the Carolina Consultation Center at 800-862-6264 and asking for the Urologist on call.