physician resources

With more than 35 specialties at The Polyclinic, we want to ensure you have the resources needed to refer your patient for care.

Refer a Patient

1. Determine which specialty or service you are referring your patient to. Visit our Specialties A-Z page for choosing the clinic. You can also download and print contact sheets below (updated quarterly).

2. Send the patient's chart notes and complete documentation directly to the clinic by phone, fax or Epic. Unless otherwise specified, a referral form is not required. If urgent, please call the clinic.

  • By Phone – Call the specialty clinic directly. For emergencies, call 911 (do not use our referral options).
  • By Fax – Send a fax to the specialty clinic directly. Unless otherwise specified, there is not an additional cover form to complete.
  • By Epic – If your office has Epic access, requests may be entered directly.

3. What to expect next – Patients can schedule their appointment once the referral is complete. Please instruct your patient to call and make an appointment. We will contact you if there is any missing information from the referral.

Referral and Procedure Forms

For most referrals, you can call and fax directly to the specialty clinic office. A general referral form is not needed. Below are forms that could be needed depending on the referral.

Stay Connected

For questions regarding a patient referral, please contact:

Emily Meeks, Marketing and Referral Specialist

Colleagues Connect

This quarterly publication provides updates for medical professionals about services at The Polyclinic. Read past issues below:



If you are a medical professional and would like to receive Colleagues Connect, please email our referral specialist.

Quick Links

Physician Care Alliance

Physician Care Alliance (PCA) is a clinically integrated network created through collaboration between The Polyclinic, Physicians Insurance, and Premera Blue Cross. PCA leverages expertise developed by The Polyclinic’s established and successful Physicians Care Network, a separate corporate entity, which has been in existence for nearly 20 years, managing risk through Medicare Advantage products. While clinically integrated networks have gained popularity in recent years, The Polyclinic’s early and enduring success with its initial network is pivotal for PCA. Physician leadership is the core of PCA.

Learn more about the Physician Care Alliance: