Phone: (517) 324-3700
The Urology Institute

New Patient Referral Submissions

A referral from providers can be submitted one of the following ways:

  1.  New Patient Referral Form below
  2.  Referral request through Michigan Health Information Network Shared Services (MiHIN) or MaxMD
  3.  New Patient Referral Form via Fax
  4. Please note if you are referring from a Corewell Health office, submissions must be sent via Holon, MaxMD or by fax.