For referring providers

Refer a patient

Referring providers can now submit patient referrals through EpicCare Link.

Use the options below to help expedite faxed referrals.

Referral pathways

How to refer

  1. Print and complete the following forms:
    1. Counseling referral form (PDF)
    2. Patient referral form (PDF)
  2. Fax completed forms to 1-512-232-3899

Patient eligibility

  • Patients must be at least 12 weeks from initial COVID-19 infection.
  • Patients with significant comorbidities should have a primary care provider actively managing these conditions.

Recommended pre-referral workup

  • Lab results: CBC, CMP, TSH, ESR, CRP, A1c
  • Cardiopulmonary evaluation (if symptoms present): EKG, chest X-ray, PFTs

Required clinical documentation

  • COVID-19 history: Include dates of infection or reinfection 
  • Symptom clarification: Specify which symptoms are likely related to long COVID
  • Differential diagnosis: Provide documentation ruling out alternative etiologies

How to refer

  1. Print and complete the following forms:
    1. Patient Referral Form (PDF)
    2. Authorization to Receive Medical Records (PDF)
  2. Fax completed forms and supporting documentation to 1-512-495-2090

How to refer

  1. Print and complete the following forms
    1. Patient referral form (PDF)
    2. Authorization to receive medical records (PDF)
  2. Fax completed forms to 1-512-495-5372

How to refer

  1. Print and complete the following forms
    1. Patient referral form (PDF)
    2. Authorization to receive medical records (PDF)
  2. Fax completed forms to 1-512-495-5709

How to refer

  1. Print and complete the following forms:
    1. Patient referral form (PDF)
    2. Authorization to receive medical records (PDF)
  2. Fax completed forms to 1-512-232-3899

Need help with patient referrals?

For help with patient referrals, call 1-833-UT-CARES (1-833-882-2737) or fax completed patient referral forms to 1-512-232-3899.

For questions about EpicCare Link, email epiccarelink@austin.utexas.edu to contact the provider relations team.

For help with accessing referrals/referring provider resources, email providerrelations@austin.utexas.edu.

What to expect after referral

  • Referrals are reviewed promptly before scheduling
  • Secure portal access for documentation and tracking
  • Multidisciplinary, team-based care with clear, timely communication
  • Seamless handoff to the referring provider
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