How to Refer a Patient to Heart & Vascular

Providers: When referring a patient to Cheyenne Regional Heart & Vascular surgical services, we request the following information:

  • A completed patient referral form
  • Your patient’s complete medical history and records, including:
    • Current medications (types, dosages, and allergies)
    • Records of surgeries/procedures
    • Diagnostic test reports (including any actual films or tracings).

Additionally, be sure to indicate the Heart and Vascular Surgical Services physician to whom you are referring your patient.

Fax your completed patient referral form with the attached medical records to the attention of the indicated physician at (307) 778-4995. If you have any questions, please feel free to contact us at (307) 778-1849.

Thank you for choosing Heart and Vascular Surgical Services!