Access Ohio

Patient Referrals

It’s as easy as 1, 2, 3! 
1. Download the Patient Referral Form.
2. Fill in the details for the patient that you’re referring.
3. Fax the completed form to one of our Access Ohio locations found on the form or here.

Or it’s as easy as completing the online referral form below and we’ll take care of rest! No need for any printing or faxing.

COVID-19 Information

Don’t delay emergency care​

  • Do not delay urgent or routine care because of COVID-19. Seek immediate care for severe or sudden health events or emergencies. Delaying medical care can be a threat to your health and wellbeing.
  • Source: Centers for Disease Control and Prevention

Call before you visit and wear a mask when you go

More information on Covid-19 and how to protect yourself and others can be found at: