Cullman Regional Medical Group

• Bariatric and General Surgery Referral Form – Venkat Kanthimathinathan, MD
• Cardiology Clinic Referral Form – Lee, Mahan, Neal, Singireddy
• Endocrinology Physician Referral Form – Lakshmi Kannan, MD
• Surgical Arts – Physician Referral Form (Evans, McBride, Moody, Thompson)
• Gynecology Physician Referral – Randy Yarbrough, MD
• Hartselle Multispecialty Clinic – Physician Referral Form
• 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
• Urology Clinic Physician Referral Form – Dukovac, Brooks
• Vascular Physician Referral Form – Michael Miller, MD
• Pain Clinic Referral Procedure Form – Cosgrove, Crisologo, Hinson

Cullman Regional Outpatient Orders

• Breast Imaging Orders
• Cardiopulmonary Rehab Patient Referral Form
• Cardiovascular Services Order Set
• Imaging Orders
• Lab Orders
• Low Dose CT Order
• 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