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REFERRING PHYSICIANS

REFERRALS

If you would like to refer a patient to one of our clinics, please download and complete the following form and fax to the appropriate location. Click here to see fax numbers by location. 

DERMATOLOGY REFERRAL FORM

 

GASTRO REFERRAL FORM

 

GASTRO REFERRAL FORM - NURSING FACILITIES

Kansas City  |  Mission  |  Leawood  |  Independence  |  Olathe  |  Leavenworth |  

Lawrence  |  Emporia  |  Manhattan  |  Topeka | Hunters Ridge

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© 2023 Kansas Medical Clinic, PA ​ - If you have a medical emergency, please call 911.  All information provided herein is for educational purposes only. If you have a medical condition, please consult a physician to get a proper diagnosis and treatment plan.

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