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Doctor Checking a Form


If you are seeking care for something other than pregnancy, our providers require a referral. 


Please have your primary care physician or current Ob-Gyn complete the referral form below and fax a referral to (616) 301-9899 (referrals must be faxed, they cannot be interfaced via Epic or sent via email). The referral must include patient demographics, insurance, records (including anything relevant to why you would need to be seen such as recent visit notes, pap history, any relevant lab work results or imaging reports), and a clinical reason for the referral. Note: a referral must come from a physician; prospective patients cannot self-refer using this form even if insurance allows for self-referral.

Advanced Ob-Gyn Referral Form


Once the complete referral is received, it will be processed by our referral coordinator. If the referral contains all necessary records and demographics, processing will take about two weeks. When it has been processed, you will receive a phone call to schedule. If the referral is missing any demographics, records, etc this may result in a delay in processing, as we will need to contact the referring provider for more information.


To check the status of a referral, please contact the referring provider's office. Some offices can take weeks to prepare and send a referral.

Please see our Prospective Patients page for more information. If you have any other questions about becoming a patient, please call (616) 971-0060.

If you are pregnant and wish to be seen for prenatal care, please call (616) 971-0060 to complete the OB screen process.

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