Referral Requests
Houston Concierge Medicine Referral Requests
Please Note
This referral request form is for current Houston Concierge Medicine patients only.
Before You Submit
Help Us Process Your Referral Efficiently
To ensure timely and accurate processing, please complete all required fields and include the necessary supporting information when submitting your referral. Incomplete or missing details may delay review.
Referral requests are processed during normal business hours and are not reviewed on weekends. Providing complete and accurate information helps our team coordinate your referral appropriately.
Standard Processing
48–72
Business Hours
Please Plan Ahead
Processing begins once all required information has been received. Same-day or next-business-day appointments may not be available, so please allow adequate time when submitting your referral request.
01 / COMPLETE
Include All Required Information
Missing patient, physician, specialty, or clinic information may delay processing.
02 / BUSINESS HOURS
Referrals Are Not Reviewed on Weekends
Requests are reviewed and processed during normal Houston Concierge Medicine business hours.
03 / PLAN AHEAD
Please Allow Adequate Time
Submit requests as early as possible when coordinating specialty care or upcoming appointments.