For referring providers

Refer a patient

Referring providers can now submit patient referrals through EpicCare Link.

You may also call 1-833-UT-CARES (1-833-882-2737) or fax completed patient referral forms to 1-512-232-3899.

Use the options below to help expedite faxed referrals.

Referral pathways

How to refer

  1. Print and complete the following forms:
    1. Counseling referral form (PDF)
    2. Patient referral form (PDF)
  2. Fax completed forms to 1-512-232-3899

Patient eligibility

  • Patients must be at least 12 weeks from initial COVID-19 infection.
  • Patients with significant comorbidities should have a primary care provider actively managing these conditions.

Recommended pre-referral workup

  • Lab results: CBC, CMP, TSH, ESR, CRP, A1c
  • Cardiopulmonary evaluation (if symptoms present): EKG, chest X-ray, PFTs

Required clinical documentation

  • COVID-19 history: Include dates of infection or reinfection 
  • Symptom clarification: Specify which symptoms are likely related to long COVID
  • Differential diagnosis: Provide documentation ruling out alternative etiologies

How to refer

  1. Print and complete the following forms:
    1. Patient Referral Form (PDF)
    2. Authorization to Receive Medical Records (PDF)
  2. Fax completed forms and supporting documentation to 1-512-495-2090

How to refer

  1. Print and complete the following forms
    1. Patient referral form (PDF)
    2. Authorization to receive medical records (PDF)
  2. Fax completed forms to 1-512-495-5372

How to refer

  1. Print and complete the following forms
    1. Patient referral form (PDF)
    2. Authorization to receive medical records (PDF)
  2. Fax completed forms to 1-512-495-5709

How to refer

  1. Print and complete the following forms:
    1. Patient referral form (PDF)
    2. Authorization to receive medical records (PDF)
  2. Fax completed forms to 1-512-232-3899

What to expect after referral

  • Referrals are reviewed promptly before scheduling
  • Secure portal access for documentation and tracking
  • Multidisciplinary, team-based care with clear, timely communication
  • Seamless handoff to the referring provider
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