Referral Forms for Providers

Partner with NCH for Exceptional Patient Care

Welcome to NCH external referring provider resource center. We’re committed to making the referral process seamless and efficient while ensuring your patients receive the highest quality specialized care.

Our experienced team of specialists across multiple disciplines, combined with our multilingual capabilities and comprehensive services, makes NCH the ideal partner for your patient referrals in Southwest Florida.

Refer a Patient

Start a new referral using our streamlined EpicCare Link system for fastest processing

Find a Specialist

Browse our comprehensive physician directory to find the right specialist for your patient’s needs

Insurance Plans

Review our contracted insurance plans and coverage options to get started

Our Services

Discover our full range of medical specialties and advanced treatment capabilities

How to Refer a Patient

Preferred Method: EpicCare Link

For the most seamless and expedited referral process, we strongly recommend using EpicCare Link. This integrated system provides real-time communication, appointment scheduling, and status updates.

Referral Process Steps

1

Access EpicCare Link: Log into your EpicCare Link portal or register for access if you’re a new user

2

Complete Referral Form: Fill out the comprehensive referral form with patient information, clinical details, and urgency level

3

Select Specialist: Choose from our directory of specialists based on specialty, location, and language preferences

4

Submit Documentation: Attach relevant medical records, imaging, and test results

5

Track Status: Monitor referral status and receive real-time updates through the portal

Alternative Referral Methods

If you don’t have EpicCare Link access yet, you can use our universal referral form while we work on getting you connected.

Universal Referral Form

Status: Currently in development

A comprehensive online form for providers not yet on EpicCare Link system today

Fax Referrals

Fax Number: (239) 624-xxxx

Send completed referral forms and supporting documentation via secure fax

Physician Outreach & Support

Physician Engagement Manager

Phone: (239) 624-xxxx

Email: physician.relations@nchmd.org?

Services: Practice visits, education, referral support

Referral Coordination

Phone: (239) 624-xxxx

Email: referrals@nchmd.org?

Hours: Monday – Friday, 8:00 AM – 5:00 PM

Request a Practice Visit?

Schedule a visit from our Physician Engagement team to learn more about NCH services and referral processes