Referring Provider Information

Thank you for considering Neurosurgical Associates, LLC for the care of your patient. To refer a patient, please complete the following Physician Referral Form. Please fax the form and all related clinic notes and diagnostic reports to 801-507-9550. The information submitted will be reviewed by the neurosurgeon of your choice, or the next available surgeon if a specific surgeon is not chosen. The patient will be contacted regarding an appointment.

• Consultation / Referral Form (pdf)