Patient Referral Portal

Please use this form to refer your patient and supply our care team with the needed documentation and patient records.

Patient Referral Form

After logging in, you will see a list of patients your clinic has currently referred to our facility for care. As our facility processes these referrals the 'status' of the referral is updated. Below is a list of the stages these referrals go through an an approximate time to allow for each stage:

• Referral Received: our facility has received your clinic's initial referral and is reviewing the information. Please allow us up to 1 business day to process this stage.
• Medical Record Review: Our facility is reviewing the patient's medical records provided by your clinic to ensure an appropriate care plan can be administered and requirements are met. Please allow up to 1 business day to process this stage.
• Patient Contact: After reviewing the patient's medica records and referral form information, our facility will contact the patient. Please allow up to 2 business days to process this stage.
• Referral In Process: We are setting up the patient and their information in our EMR. Please allow up to 1 business day to process this stage.
• Patient Admitted: Following our contact with the patient, we will admit them and schedule a visit. Please allow up to 1 business day to process this stage.

If the appropriate time has elapsed for a specific status and you do not see the referral process advacning after that time, please contact our office at: 888-765-9999 or email us at referrals@fmcna.com