Refer a Patient (Student Clinic)
- Complete the fillable Patient Referral Form PDF and SAVE the file where you can easily access it, like on your desktop. Leave the file name as Patient Referral Form.
- Either drag & drop the file you saved into the top box or click ‘Browse your device’ and find the file.
- In the Description Box, put the Patient's Name.
Submit images and radiographs below. In the Description Box, put the Patient's Name.