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Refer A Patient—Plastic Surgery

Now Taking Physician Referrals

Thank you for referring your patient to Ï㽶ÊÓƵ of Utah Health. We value our relationship with referring physicians. Please fill out the form below or submit your request through the U of U Health MedPic app. 

Fax applicable records to 801-581-7719

Office Hours: Monday to Friday 8 a.m. – 5 p.m. 

 If this is an urgent request, please call 801-581-7719 during office hours or 801-581-2121 outside of office hours. 

Referring Physician Information

Patient Information

basic address

Insurance Information

Secondary Insurance