For Physicians

Click this Link for the Referral Form

To refer a patient to any physician at Emerald Coast Neurology please do one of the following:

  • Complete referral using Order Facilitator
  • Download and complete our New Patient Referral Form that can be faxed to (850) 438-3740

It is our goal to make the referral process as efficient and timely as possible. In order to achieve this we ask you to include:

  • All possible documentation regarding patient’s condition
  • Any radiology reports
  • Recent office notes
  • Copy of authorization or authorization number
  • Copy of insurance card and driver’s license

Our new patient coordinator team can be contacted directly at : 850-438-1136 opt #2

We look forward to providing your patient with the best quality of care.