Specialists Referrals

Specialists Referrals Policy

Pediatric Associates of Alexandria asks that you submit requests for referrals at least five business days prior to your scheduled appointment with your child's specialist. Please provide: the child's full name, date of birth, parent or guardian's name, contact phone number, name of insurance, date of appointment, specialist's complete name, office phone number, and diagnosis or reason for office visit. Referrals may be faxed, emailed or picked up at our office.

It is the responsibility of the parent or guardian to submit a referral request at least five business days prior to the child's appointment with the specialist. Only under extreme emergency circumstances will same day referrals be approved and completed. Referrals cannot be back dated, and in most cases, your insurance requires 24 to 48 hours notice to approve (giving us authorization).

• Referrals Request Form