Patient Referral

Refer your patient to Upperline Health

Download the referral form, select an Upperline clinic, and fax the completed form.

Provider reviewing paperwork

How to refer a patient

Our care team will contact the patient directly to schedule their visit.

Download Form

1. Download referral form

Download and complete the Upperline Health patient referral form.

Choose a Clinic

2. Choose a clinic

Find the Upperline clinic closest to your patient.

Fax a Document

3. Fax a completed form

Send the completed referral form to the clinic using the listed fax number.

Find an Upperline Health Clinic

Locations closest to

Why Refer to Upperline Health

Upperline Health works alongside your care as an extension of your team to connect patients to the right specialty services and keep them on track beyond the visit.

Telehealth Visit
Care

Specialty care that works in sync

Primary and specialty care work together to close gaps and improve continuity of care.

Continuous Care

Follow-through beyond the visit

We stay involved beyond the visit, managing scheduling, coordination, and ongoing care so patients stay engaged and follow through on next steps.

Connected Care

Clear, consistent communication

You stay informed with timely updates throughout your patient’s care.

Find a Clinic Near Your Patient

Search by location to find the closest Upperline clinic and access referral details.