UR Medicine / Transplant Institute / Contact Us / Patient/Referring MD Referring Physicians - Request an Appointment for Your Patient place field "FirstName" below Name First Name place field "LastName" below Last Name place field "DOB" below Date of Birth place field "Gender" below Gender Male Female place field "City" below Contact Info City place field "State" below State place field "Street" below Street place field "Zip" below Zip place field "Phone" below Phone Number place field "AltPhone" below Alternate Phone Number place field "PreferredContactMethod" below Preferred Contact Method Primary Phone Number Alternate Phone Number place field "Email" below Email place field "MDFirstName" below Referring MD Contact Info First Name place field "MDLastName" below Last Name place field "MDCity" below City place field "MDState" below State place field "MDStreet" below Street place field "MDZip" below Zip place field "MDPhone" below Primary Phone place field "MDAltPhone" below Alternative Phone place field "MDPreferredContactMethod" below Preferred Contact Method Primary Phone Number Alternate Phone Number place field "MDFax" below Fax Number place field "MDEmail" below Email place field "PrimaryCareProvider" below Additional Information Primary Care Provider place field "MDImaging" below Have any imaging studies been done? Yes No place field "ReferringSpecialist" below Referring Specialist (if known) place field "VisitReason" below Reason for Visit place field "Organ" below If this is an urgent referral, please call 585-275-5875 and ask to speak to the coordinator on call Organ Liver Kidney Pancreas Heart
