Refer a Patient

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The process is simple! Please fill out the form below with your contact information. All requests received Monday through Friday between 8 am – 5 pm CST will be answered within 30 minutes. After hours requests will be answered first thing the next business day. Alternatively, you may email us at or call 888-566-8773 or 504-831-2123. Requests received after hours or on weekends will be handled by our GIFTED after hour staff who are ready to assist you.

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