Fact Sheet Display

David Grant USAF Medical Center - Outpatient referrals and physician phone consultations

60 MDG

60 MDG


The following general Information is for referring providers (i.e., private practice, NorthBay, VacaValey, Queen of Valley, UC Davis, UCSF, VA, etc.) wishing to consult with, and/or refer with medical staff at David Grant USAF Medical Center: 

Outpatient referral coordination
If your patient requires a referral to our specialty services, we will process your request to determine the patient's eligibility, check the availability of the requested service and assist the patient is getting an appointment. We will also provide you with information on the status of previous referrals and assist you with getting the result of the referral.

Physician-to-physician phone consultations
If you would like to arrange a phone consultation to discuss a unique case with one of our specialists, please call us so we can coordinate with the on-call physicians. We can then arrange the referrals if one is needed.

Our Services
 - Find a DGMC Clinical Specialist
 - Outpatient Referrals and Physician Phone Consultations
 - 24/7 Transfer Center

Request a referral or consultation
Our specialty clinics require a referral from a primary care provider. Please contact our Referral center so we may facilitate the referral for you.

For TRICARE Prime Patients within one hour drive of DGMC:
All specialty services are available through the "Right of First Refusal" or ROFR process. These referrals will come to DGMC from TriWest, and the Referral Management Center will arrange the appointment with the patient. Please submit your referral request through TriWest.

For TRICARE Standard or TRICARE for Life Patients:
We are pleased to offer availability for certain services for these patients. These services are:

Cardiology/Cardiothoracic Surgery  
General Surgery   
Orthopedic Surgery  
Radiation Oncology 

Arrange a Patient Transfer 24/7
Who is eligible to be Transferred?

TRICARE Prime
TRICARE Standard
TRICARE for Life (Over 65 with Medicare Parts A&B)
VA Patients for Heart/Lung/Vascular or Inpatient Mental Health

DGMC's Admissions Call Center is staffed 24 hours a day, seven days a week. Please call (707) 423-7790 or (877) 843-2457 to arrange the transport.


Referring Physician Checklist
Click here for referral form for non-TRICARE Prime patients 
(requires .pdf reader like Adobe Acrobat or FireFox Fox-IT)

The following describes some of the information we may require when referring a patient. Please be prepared with this information when you contact us for a referral. You may use this form and send it to us, or we can gather this information over the phone.

Phone: (707) 423-7641
Fax: (707) 423-7535
 
Your contact information:

·  Name
·  Address
·  Phone Number
·  Fax Number
·  Email

Information about your patient:

·  Name
·  Birth date
·  Address
·  Phone Number
·  Social Security Number
·  Insurance Information

Your patient's complete Medical History and Records:

·  Medical History
·  Surgeries/Procedures including Operative Reports
·  Devices: type/settings

Description of your patient's current Medications:

·  Type(s)
·  Dosages
·  Allergies

Diagnostic Test reports plus actual films or tracings - as they apply to the patient:

·  Cardiac Catheterization: actual film plus report
·  Echocardiogram: actual tape plus report
·  Thallium Stress Test: actual x-ray film plus report
·  Chest x-ray, CT scans, ultrasounds: x-ray films plus report
·  Electrocardiograms: actual tracings if available
·  Electrophysiology testing: actual tracings and reports
·  Vascular laboratory: actual ultrasound images, pressure tracings and reports
·  PET scans, bone scans, films plus reports
·  Pulmonary evaluation consultation plus pulmonary functions, and ABG reports
·  Procedures - EGD, Colonoscopy, EUS, Bronchoscopy, CT guided biopsy reports plus pathology and slides for review