Refer a Patient to KHC

Convenient Access to Advanced Dialysis Options

At The Kidney & Hypertension Center, we want patients to get the care they need. And that means making it as simple as possible for referring physicians to send their patients to us.

If you have a patient who requires dialysis, our team of specialists will work with you to develop a treatment plan to address their needs. Referral requests are answered promptly and appointments are scheduled quickly with minimal wait time.

Physician Liaison Service

Physician liaisons are your direct connection to care at The Kidney & Hypertension Center. They can expedite the referral process, help you obtain follow-up information, and help resolve any issues that come up with your patient’s care. Physician Liaisons can also visit your practice or medical group to provide more information.

Phone: (833) 600-1318
Email: referrals@khccares.com
Monday to Friday, 9 a.m. to 5 p.m. Eastern Standard Time

The Physician Liaison Service responds to emails as soon as they receive them If you call the service outside regular working hours, a liaison will contact you on the next business day.

"*" indicates required fields

PATIENT INFORMATION

First Name*

Last Name*

Email*

DOB*

Home Phone*

Work Phone

Cell Phone*

Parent or Caregiver*

Address*

City*

State*

Zip*

Insurance

CONSULTATION REQUEST INFORMATION

Diagnosis/ICD-9/10*

KHC doctors

Specialty

Reason For Consultation*

By providing the information requested and signing below, you agree that we may initiate treatment following consultation or perform medically necessary diagnostics in association with this consultation. We look forward to collaborating with you on your patient’s treatment plan.

REFERRING PHYSICIAN INFORMATION

Referring MD First Name

Referring MD Last Name

Specialty

Phone

Fax

Primary Care Provider First Name

Primary Care Provider Last Name