Referring Doctors

Referring Doctors

We have conveniently provided our referral forms below so that you can fill them out in the comfort of your office, and have the patient bring them to us.

Referral Form

TIPS FOR REFERRING A PATIENT

• If possible, please appoint the patient for a examination with our office while they are still in your office. This way we can get your patient the earliest and most convenient appointment time possible.
• When the patient leaves your office, please email the referral information to our office at: office@southernrootsky.com and highland@southernrootsky.com.
• When emailing the referral slip, please include the radiographs and insurance in-formation for the patient being referred. We prefer to have an FMX so we can diagnose as much as possible, even if you are sending the patient over for a limited exam.
• If you do not have digital radiograph capabilities, please mail us a copy of the radiographs to:
  • Drs. Estes & Dr. Disney, 8136 Mall Rd, Florence, KY 41042
  • Dr. Prabhu, 201 Martha Layne Collins Blvd., Ste B., Highland Heights, KY 41076

Please let us know if you have any appointed-back preferences. We want to make sure we facilitate the patient going back to your office in a smooth and efficient manner.