Surgery: Patient Referrals

Welcome Referring Physicians! Thank you for trusting us with the care of your patient. Please fax this form to (937) 208-6154 along with any records pertinent to the reason for consult. Upon receipt of records, we will call the patient with an appointment date and time. We will notify your office when this appointment is scheduled. If you have any questions, please call our office at (937) 208-2552. As always, we appreciate your referrals to Wright State Surgery.