- Due to the volume of patients being referred to our center, the Autonomics Clinic requests that all of the following documents be sent with the initial patient referral:
- Referral letter (For an example, click here)
- Referring provider information (name, specialty, address of practice, phone and fax numbers)
- Patient demographics (name, DOB, address, phone number, and insurance information)
- Three (3) complete sets of orthostatic vitals (As a reference or to use our Orthostatic Vitals Worksheet, click here)
- One to three (1-3) office visit notes within 3 months of the initial referral
Please fax or mail the above documents to:
Autonomic Dysfunction Clinic
Vanderbilt Heart & Vascular Institute
1215 21st Avenue South
Nashville, TN 37232
Phone: 615-322-2318 Fax: 615-936-8208
Phone: 800-288-5000, ext. 22318
- Once we have received the referral, we will make one attempt to contact the referring provider to request any missing documents.
- Once all documents have been received, one of our providers will review the records and determine whether the patient is an appropriate candidate and would benefit from being seen in our Autonomics Clinic.
- Please note that the referral and determination process can take some time as we receive numerous referrals each day. However, we appreciate your referral and are fortunate to provide care to the majority of patients who are referred to our clinic.
- If the patient referral is rejected, the referring provider will be notified with a brief explanation.
- If the patient is accepted, our scheduler will contact the patient to schedule a consult appointment along with any appropriate diagnostic testing determined by the reviewing provider.