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If physician referrals are required, please allow Orlando Family Medicine at least one week prior to the scheduled appointment. Most likely, the Orlando Family Medicine team will require specific information to complete the referral.  

The Required Physician Referral Information includes: 
Patient name
Patient contact information
Patient primary health insurance information
Physician the patient is being referred
Practice phone and fax numbers
Date of the appointment
Reason for the referral
Whether referral is for an office visit or a specific procedure (such as surgery)
If visit is for a specific procedure, where is it going to be performed (office or hospital)
If you are not sure you need a referral, contact your health insurance provider to clarify. Based on the type of insurance plan and the reason for the visit, they should be able to assist in determining if you are required to provide a referral. 
You can download the Physician Referral Form below and mail it to the practice address, fax request to 407.422.0267 or email it to