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Physician Resources

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Cullman Regional Medical Group

  • Cardiology Referral Form
  • General Surgery Referral Form – Bitterly, Evans, Meherg, Thompson
  • Hartselle Health Park Physician Specialty Clinic Referral Form
  • Imaging Patient Referral Form
  • Interventional Pain Clinic Referral — Victoria Clay, MD
  • Neurology Referral Form — Murray and Siddiqi
  • Obstetrics/Gynecology Referral Form
  • Orthopedic Surgeon Referral Form
  • Podiatry Referral Form – OCampo
  • Pulmonology Referral Form
  • Sleep Medicine Consult Referral
  • Urology Referral Form

Cullman Regional Outpatient Orders

  • Breast Imaging Orders
  • Cardiopulmonary Rehab Patient Referral Form
  • Cardiovascular Services Order Set
  • Hospice & Homecare Referral Form
  • Hyperbaric and Wound Care Referral Form
  • Imaging Patient Referral Form
  • Interventional Pain Clinic Referral — Victoria Clay, MD
  • Lab Request Form
  • Lung Screening Order
  • Outpatient Rehab Referral Form
  • Pre-certification request form
  • Radiology Report Request
  • Sleep Study Direct Referral

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