Forms

Consult Request Form 

Referring Physicians can now complete a Consult Request Form to request an appointment with our specialty clinics. This online form was especially designed to allow you to request appointments at your convenience.

Radiology Requisition

U-M Radiology Services are available at our hospitals and outpatient facilities in various communities. For detail, view Radiology Services by Location.

GI/Hepatology Referral Forms

Oral & Maxillofacial Surgery Referral Forms

Transplantation

Additional Forms