Refer Someone
Below are commonly used referral forms for FirstHealth services and specialties. If you don't see the form you need, please contact us.
Centralized Scheduling: (910) 715-APPT (2778)
Back & Neck Pain
Behavioral Services
CareLink
Casirivimab/Imdevimab Infusion
Chest Center
Clara McLean Hospitality House
Clinical Trials
Colorectal Surgery
Community Health Services
Dental Care
Diabetes & Nutrition Education Services
ENT, Head and Neck
Gastroenterology
General Surgery
Heart Services
Home Care
Hospice & Palliative Care
Infectious Diseases
Imaging/Radiology
- Convenient Care - Diagnostic Imaging
- Hoke Campus - CT
- Hoke Campus - Diagnostic Imaging
- Hoke Campus - MRI
- Hoke Campus - Nuclear Medicine
- Hoke Campus - Ultrasound
- Montgomery Memorial Hospital - Diagnostics
- Lee Campus - CT
- Lee Campus - Mammo and Bone Density
- Lee Campus - MRI
- Lee Campus - Ultrasound
- Moore Campus - Angiography
- Moore Campus - CT
- Moore Campus - Diagnostic Imaging
- Moore Campus - Imaging & Lab Preventative Tests
- Moore Campus - Mammo and Bone Density
- Moore Campus - MRI
- Moore Campus - Nuclear Medicine
- Moore Campus - Moore Free Health Clinic
- Moore Campus - PET
- Moore Campus - Ultrasound
- Richmond Campus - Diagnostic Imaging & CT
- Richmond Campus - Nuclear Medicine & Ultrasound
- Richmond Campus - MRI
- Southern Pines
Laboratory
Lung Cancer Screening Program
Medical Fitness Program
Neurosurgery & Spine
Nutrition Counseling
Orthopaedics & Joint Replacement
Outpatient Therapy
- Antibiotics Referral
- Albumin Infusion Referral
- Aranesp Referral
- B12 Monthly Referral
- B12 Weekly Referral
- Carboxymaltose Injectafer Referral
- Complex Wound Care Referral
- Customer Infusion Builder with Additives Referral
- Ferumoxytol (Feraheme) Referral
- Heparin Flush for VAD and PICC Referral
- Intravenous Immune Globulin Infusion (IVIG) Referral
- Iron Sucrose (Venofer) IV Daily Referral
- Iron Sucrose (Venofer) IV Weekly Referral
- IV Hydration Referral
- Pre-Procedure Sodium Bicarbonate Infusion Referral
- Prolia Referral
- Rabies Series Vaccine Referral
- Reclast Referral
- Remicade Referral
- Rituxan (Rheumatology) Referral
- Simple Wound Care Referral
- Solumedrol Referral
