patient referrals

A smiling female doctor and a young girl both give thumbs up to the camera, with a whimsical ice cream cone painting behind them.

ways to submit a referral

By phone call: 937-641-4000
Hours: 7:30 am – 5:00 pm
Monday – Friday

By fax: Local fax: 937-641-4500
Toll-free fax: 1-866-891-6941
Hours: 24/7

referral options

Please use the forms below to refer to one of our specialties. For more information about referring to a specific specialty, view our referral guide to services.

abs, imaging & testing referrals

To order labs, imaging or testing, please use these forms. Any genetic testing requires a referral to medical genetics using the specialty services form. View the lab manual here.

online referral for specialty care services

together, we care for kids.

From patient referrals to continuing education and more, Dayton Children’s is here to support you in every step of your journey as a healthcare professional.