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Physician Referral Form

Refer a Patient to Benefit Health System

Thank you for your interest in referring a patient to Benefit Health System. To refer a patient, please complete the physician referral form below. After you submit the referral form, we will contact your office or the patient (as needed) to complete the medical intake process and to schedule the patient's appointment.

Forwarding Patient Medical Records

Please forward the patient's medical records to Benefit Health as soon as possible so we may route them to the appropriate provider or location. Medical records may be faxed to 319-221-1450 or mailed to:

Benefit Health System
ATTN: Medical Records Processing
415 12th Ave SE
Cedar Rapids, Iowa, 52401

If you have questions about referring a patient or forwarding patient medical records please call us at 800-589-1171 anytime between 7 a.m. and 7 p.m. Central Time, Monday-Friday.

We take patient privacy protection seriously. All information on this form is submitted through a secure server to protect patient health information.