Skip to content
  • For Medical Professionals
  • Careers
  • Giving
  • News & Media
  • About Us
  • Contact Us
  • Search
Halifax Health Logo with Belvedere Tower on Top of the name.

Open menu

  • OUR
    DOCTORS
  • SERVICES
  • OUR
    LOCATIONS
  • PATIENTS &
    VISITORS

Browse Doctors by Letter

ABCDEFGHIJKLMNOPQRSTUVWXYZ

Key services

  • Cancer Care
  • Care at Home
  • Diabetes Care
  • Emergency Services
  • Endocrinology
  • Heart & Vascular
  • Hospice Care
  • Labor & Delivery
  • Lung Care
  • Neurosciences
  • Orthopedics
  • Pediatrics
  • Plastic Surgery
  • Primary Care
  • Rehabilitation
  • Transplant
  • Urgent Care
  • Urology
  • Wound Care
Home › For Medical Professionals › Referrals › Forms

Referrals

  • Surgery Scheduling
  • Forms

Forms

For Referring Physicians Only: Forms for download, provided for convenient referral of patients.

  • Outpatient Surgery A.M. Admission Orders
  • Surgical Consent – English
  • Surgical Consent – Spanish
  • Fax Scheduling Form
  • How to Use the Scheduling Portal – Instructions  
  • OR Scheduling Portal Access Request Form
  • 386.425.4000
  • Request An Appointment
  • Primary Care Providers
  • Billing & Pricing
  • YouTube
  • Facebook
  • Instagram
  • Twitter

Stay in touch with
Halifax Health!

Services & Treatments

  • Our Services
  • Our Doctors
  • Treatments

For Medical Professionals

  • Residency & Fellowship
  • Referrals
  • Physician Opportunities
  • Radiography Program
  • Medical Library
  • Nursing Education
  • Physician Portal
  • Medical Staff Services

Billing

  • Pay My Bill
  • Patient Portal
  • Price Estimates and Transparency

About Us

  • Board of Commissioners
  • Financial Statement
  • Leadership
  • Meetings
  • Our History
  • Partnerships
  • Privacy Policy
  • Terms of Use
  • Testimonials
  • YouTube
  • Facebook
  • Instagram
  • Twitter
Halifax Health
Copyright 2023 Halifax Health. All Rights Reserved