Skip the ER. Admit Directly.

For qualifying patients, ConnectCare Hospitalists can arrange direct admission to one of our 9 partner hospitals — no emergency room visit required.

How Direct Admission Works

01

Call or Submit

Reach us by phone or via the form below with patient and contact details.

02

We Coordinate

Our team arranges the admission directly with the receiving hospital.

03

We Follow Up

You receive updates throughout the stay and a discharge summary at the end.

Physician Referral Form

Referring Physician Full Name *

Practice / Clinic Name *

Callback Phone Number *

Preferred Hospital Location *

Urgency Level * Routine Elevated Urgent

Best Time to Reach You *

Additional Notes (optional, max 300 characters)

Please do not include patient name, date of birth, diagnosis, or any other patient-identifying information. This form is for physician contact information only.

Prefer to call?

816-912-2100