For Referring Providers

Appointments: (703) 560-2236

Steps for Patient Referrals to the Pediatric Surgical Group:

• We provide you with an easy-to-use Consultation Form.
• Please complete the Consultation Form, include the patient’s demographics, patient’s insurance information, a recent progress note if available, and send by FAX to (855) 208-6018. Please provide the best contact number for your patient. Or, you may refer your patient to call us directly and we will fax you a Consult Request Form to fill out and fax back to us.
• Our scheduling team will call the patient/family to schedule an appointment with one of our surgeons.
• If you are referring for surgery, our scheduling team will obtain preauthorization for the surgery/procedure, if required by the patient’s insurance plan.
• After the surgery is completed, our surgeon prepares a report which is sent to you at the office fax number listed on Consultation form.

Thank you for the referral to the Pediatric Surgical Group.