Referring Physician Information

We are thankful for all of the referrals sent to us from you as a physician.  Below is the referral form (optional) for prospective patients.  We ask that referring physicians send a profile sheet of the patient including insurance information.  We also ask that any medical records and recent exams be faxed a long with the referral form and profile sheet.

Patient Referral Form Patient Referral Form

Referrals may be sent via fax to one of the two following numbers:  833-464-5416 or 817.701.4258, or you can call and ask to speak to our referral coordinator at 817.701.4253.

Once we receive the referral, we will contact the patient within 1-3 days. We will then follow-up with the referring office with any office notes and future visits or surgeries. If a patient needs to be seen immediately, please contact our office via phone to get the patient in same day or day after.

We pride ourselves on striving for an open and professional relationship with our referring physicians and do our best to keep you up to date and in the loop about your patients.   We are here to make the process easier for you so if any special requests are needed, please don’t hesitate to call our office.

Thank you for lending such a helping hand with Bianco Brain and Spine –
Providing cutting edge and patient centered neurosurgical care.