Referring Physicians

Refer a patient

If you are a patient, let us direct you to our patient forms. Click here. For physician offices, fill the form below. Otherwise, if you prefer, you can

  • Fax a referral to The Urology Place. 888-316-9464
  • Email us messages @
  • If you need to call us, the number is 210-617-3670

Physician referral form

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