Dr. Uzma Samadani, MD Ph.D Neurosurgeon, US Neurosurgery Associates

Dr. Samadani collaborates with several physicians, surgeons and hospitals. She will be glad to speak with physicians about any special needs of their patients. Please fillin the following referral form and, upon review Dr. Samadani will reach out to you.

Form data is secure and is transmitted via encrypted secure line in compliance with HIPPA requirements. All fields are required.

Referral Form

How do I refer a patient?

To refer a patient to Dr. Samadani, you can download and fill out our referral form and fax to (610)123-4567 (Attention: Patient Refferal) or by calling us at (610)123-4568. Our team is available M-F 8 a.m. - 5 p.m. for any questions you may have.

Please contact our Referring Physician line for help with all your needs, including:

Obtaining information on our clinical specialists and services.
Scheduling and confirming patient appointments.
Assistance in the resolution of any service-related issues.

Please give the following information to schedule your patients:

Patient demographic information including full address.
Patient insurance information.
Patient medical history.
Any special needs that will require facilitation once the patient arrives.
Reason for referral.

We will schedule an appointment at the patient's convenience and notify you once the appointment is scheduled.

Patient Referral

Referral Form