Refer a Patient
To our primary care partners in the following counties: Dane, Rock, Green, Lafayette, Iowa, Grant, Richland, Sauk, Columbia, Dodge, Jefferson and Walworth.
To refer your patient to the Specialty Care Free Clinic, simply click, print, complete and fax the appropriate referral form with pertinent information to 608-827-2344.

We ask that you also print and provide your patient with our short information sheet explaining next steps. These are available in two languages:
Currently available at Specialty Care Free Clinic for adults and specialist-approved 14-17 year olds:
Dermatology
Diabetic Nurse Education
Cardiology
Chiropractice
Endocrinology
ENT
General Surgery
Gynecology (not including infertility issues)
Hepatology
Mental Health
Nephrology
Neurology
Ophthalmology
Optometry
Orthopedics
Palliative Care
Physical Therapy (including pelvic floor and dry needling)
Podiatry
Psychiatry
Pulmonology
Rheumatology
Sports Medicine
Urology (not including infertility issues)
Appointment availability and wait times may vary by specialty.
Please don’t hesitate to contact us directly if we can better assist your referral process!