Referring Physicians

Referring Physicians

Urology of Indiana Patient Referral Form

Refer patients to Urology of Indiana via our secure online portal.

Urology of Indiana has made the patient referral process quicker and easier. Referring providers are able to complete this task securely online. Paper-based referral forms and faxing are no longer needed.

To refer a patient, simply type this HIPAA-compliant link into your browser and follow the prompts:

  • You can refer up to 5 patients at one time.
  • There is a function to attach files such as lab results, notes, etc.
  • By providing your office fax number on the referral, we will confirm via fax when a patient appointment has been scheduled with us.

If you have problems or questions, please contact us at 877-362-2778; Extension 2.