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Authorizations for specialist visits and special testing procedures If you are requesting that a referral to be done by our office, the patient must meet the following guidelines. The patient must have been seen in the last 3 months in our office for this condition and Dr Dykema must have recommended this specialist or procedure The patient must have Dr Dykema listed on their card or with their insurance as their PCP if the patient has an HMO insurance. The patient must have contacted our office with the authorization request at least 7 days prior to their appointment time. Except in the case of a true life threatening emergency, Dr Dykema will not make exceptions if these guidelines have not been met. If you are a patient, a specialist or a testing facility and the patient is at their appointment now or if you are calling with less than 7 days notice, you must cancel your current appointment, reschedule, and call us back with your new appointment time and 7 days notice. We will not make exceptions for non emergencies. To request a referral, please provide us with the following. Your name and contact phone number(s) The patients name and contact phone numbers The patients date of birth The name of the doctor or procedure The reason for the visit or test The name and address of the doctor or testing facility The date and time of the appointment The fax number of the doctor or testing facility Referrals are completed within 7 days of your request and will be forwarded to the doctor or facility by fax. You may contact the specialist or facility directly to check on the status of your referral, or you may leave us a message.