Refer a Patient

Thank you for your referral to the Henry Ford Medical Group. A representative will respond to your request the same day if it is received by noon and next business day if after. If you need faster service, please call the Referring Physician Office at 1-877-434-7470 for assistance.

* Asterisk indicates required field.

Referring Physician Information
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Communication Preference


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Gender

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(mm/dd/yyyy)
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Is this insurance an HMO?

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Is this related to a work injury?

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Will an interpreter be required

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Appointment Information
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(Please be specific and state area of involvement)
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Schedule Appointment Online

** Check with your insurance carrier for coverage limitations.

If you can't find a date/time that works for you please call the provider’s office. Not all appointment types at all locations are available online.

Henry Ford Health System is committed to ensuring our Deaf or hard-of-hearing patients and visitors have equal access to all services. We provide the appropriate auxiliary aids and services, including qualified sign language interpreters, TTYs and other assistive listening devices, at no cost. To request assistance, call 313-916-1896 or email CommunicationAccess@hfhs.org.

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