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- Sutter Medical Foundation Specialty Consultation Referral Request 2008
Get Sutter Medical Foundation Specialty Consultation Referral Request 2008-2024
Ember Name Group / IPA Name Date Date of Birth Health Plan Insurance ID # MRN# (SMG/SWMG only) Authorization # Clinician Referred To # of Visits Effective Date Expiration Date Specialty Address Phone Number Fax Number Appointment Date / Time Appointment Type Consult Only (1 Visit) Consult and 2 Follow Up Visits Transfer of Care - # of Visits (Requires Specialist Approval) In-Office Procedure Diagnostic Testing Brief Medical History (REQUIRED) Work-up To Date Diagnosis CPT.
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HIPAA FAQ
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Request a Referral Call (888) 834-1788 or chat with an agent by choosing an option below, Monday through Friday, 8:00 am – 5:00 pm PDT.
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Call the Nurse Advice Line at (855) 836-3500.
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Sutter Health Plus can help you get an appointment if you need assistance — simply call Sutter Health Plus Member Services at (855) 315-5800. We also offer a Nurse Advice Line that is available 24-hours a day, seven days a week.
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To make your primary care appointment, you can call your local clinic or login to My Health Online to request an appointment online.
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Sign in now. If you're a Sutter Health Plus member and you have questions about your plan, call (855) 315-5800 Monday through Friday: 8:00 am – 7:00 pm, or use our Online Contact Form. To schedule Video Visits with your provider or a Sutter Walk-In Care clinician, sign in to My Health Online.
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Call the Nurse Advice Line at (855) 836-3500.
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Sutter Medical Foundation (866) 681-0736. Sutter Pacific Medical Foundation (866) 681-0739.
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Chat with a Referral Agent Chat live with our team Monday through Friday, 8:00 am – 5:00 pm PDT, or call us at (888) 834-1788.
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