Cullman Regional Medical Group

• Bariatric and General Surgery Referral Form – Venkat Kanthimathinathan, MD
• Endocrinology Physician Referral Form – Lakshmi Kannan, MD
• Gynecology Physician Referral – Randy Yarbrough, MD
• Orthopedics & Sports Med Physician Referral Form – Bergquist, Gould, Hirsbrun
• Pulmonology Physician Referral Form – Bullard, Cole
• Spine Physician Referral Form – Phillip Kravetz, MD
• Turning Point Health Center Referral Form (Psychiatry) – Byrd & Tennant
• Pain Clinic Referral Procedure Form – Cosgrove, Crisologo, Hinson
• Hartselle Physician Specialty Clinic – Referral Form
• Surgical Arts Physician Referral Form — Evans, Thompson
• Cardiology Clinic Referral Form – Lee, Mahan, Neal, Singireddy

Cullman Regional Outpatient Orders

• Breast Imaging Orders
• Cardiopulmonary Rehab Patient Referral Form
• Cardiovascular Services Order Set
• Lab Orders
• Outpatient Sleep Study Order Form
• Pre-certification request form
• Radiology Report Request
• Semen Analysis Specimen Requirement Checklist
• Wound Care Referral Form
• Pain Clinic Referral Procedure Form – Cosgrove, Crisologo, Hinson
• Lung Screening Order (Low Dose CT)
• Imaging Orders