Patient Referral Information

Thank you for your interest in Lakeview Medical and Psychiatric Healthcare services. To start the referral process, please provide the requested documents below.

Note: This referral request page is for physicians and health care providers only. If you wish to refer yourself or a loved one, please utilize the New Patient Information tab located at the top of the webpage.

Referral Request Information Required

Please provide our office with the following information:

Referral Source
Patient Information
Patient Documents Needed: Facesheet, History & Physical, Medication List, Physician Order

Please Provide Information By Fax

Fax: 309-276-0615