Refer A Patient

University Surgical Associates (USA) is pleased to offer its regional referring physician offices the ability to schedule patient appointments via phone, fax, or by completing an online form.

Once USA has received your request, you will be notified by fax or telephone regarding the status of your request. If you should encounter any problems please contact USA at (423) 267-0466.

Ready to
Refer Now?

Online Referral Form

Referral Forms To Print + Fax

Forms faxed after 4:30 p.m. will not be scheduled until the following business day. Along with this form, please fax: demographics, office notes, tests, studies, ultrasounds, lab results and legible copies of insurance card(s).

Dayton Office
Vascular Access
Other Locations

Refer A Patient

University Surgical Associates (USA) is pleased to offer its regional referring physician offices the ability to schedule patient appointments via phone, fax, or by completing an online form.

Once USA has received your request, you will be notified by fax or telephone regarding the status of your request. If you should encounter any problems please contact USA at (423) 267-0466.

Ready to
Refer Now?

Online Referral Form

Referral Forms
To Print + Fax

Forms faxed after 4:30 p.m. will not be scheduled until the following business day. Along with this form, please fax: demographics, office notes, tests, studies, ultrasounds, lab results and legible copies of insurance card(s).

Dayton Office
Vascular Access
Other Locations

16 Specialty Services From Over
30 Skilled Surgeons

Today our network extends to more than 6 cities in the region. Search our network of surgeons and nurse practitioners by specialty or location.

View Our Network Of Physicians

16 Specialty Services From Over
30 Skilled Surgeons

Today our network extends to more than 6 cities in the region. Search our network of surgeons and nurse practitioners by specialty or location.

View Our Network