Referring Physicians Online Form

Thank you for your interest in referring your patient to Orthopaedic Associates of St. Augustine. We appreciate your confidence in the ability of our physicians and staff to provide the highest level of orthopaedic care to your patient.

As part of our commitment to provide better communication and efficiency between our practice and our referring groups, we have created an online referral form to better manage and track your referral to our practice. Once you have completed the form, making sure to complete the required information fields, you will receive a confirmation of your referral submission. Within 24 hours of receipt, Orthopaedic Associates of St. Augustine will make contact with your group and the patient to complete the referral process and schedule an appointment with the patient at a time and date that is convenient.

We hope that you find this page useful as it also contains important forms that we require to better serve your practice and the patient. If you have any questions or comments about the page or the forms provided by our office, please feel free to contact our referral/appointment representative at: (904) 209-1051 or fax (904) 209-1032.

We take seriously our responsibility to protect your personal information. That’s why we use Comodo Secure SSL Security to encrypt all sensitive data transmitted from your computer to ours. You can click on the Comodo Secure Seal below to check on the validity of our security certificate if you’re concerned. SSL encryption is the defacto standard in Internet transmission security, allowing your computer to make sure of who we are, and protecting your data so that no one else may read it.

Fields marked with an * are required.