Corpus Christi
Office: (361) 694-5311
Fax: (361) 808-2069

Rio Grande Valley
Office: (956) 688-1208
Fax: (361) 808-2159

Fax information required by referring physician:

  • DCH Patient Referral Form (Script signed by PCP)
  • Patient and guarantor demographics (Phone, DOB, SSN, address, etc.)
  • Insurance/Medicaid card (Front & Back)
  • Last history and physical
  • Immunization record
  • Pertinent lab work, ccans and X-Rays

Patient must bring to appointment:

  • Patient must be accompanied by parent/guardian (with ID) who know history
  • Immunization card
  • Insurance card
  • Current medications
  • Current medications, frequency and dosages (please include medications that are used only when needed)