---
title: Refer a Patient to RCOG | Georgia Radiation Therapy
description: Request an appointment at one of our eight radiation oncology clinics in Georgia. Choose cancer treatment close to home. Treating all types of cancer.
---

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# Refer a Patient

![request-an-appt (1)](https://georgiaradiationtherapy.com/hubfs/request-an-appt%20(1).jfif)

To refer a patient to one of our physicians, you can fill out our [online form](https://app.smartsheet.com/b/form/6920a2ce28194a74bbafdc25e6bd1f2b).

Be prepared to provide the following:

- Name and phone number of the patient
- Referring physician contact information
- Information on the patient’s insurance card(s)
- Patient diagnosis
- Patient medical records

[![Refer a Patient](https://no-cache.hubspot.com/cta/default/9311986/49160063-12ea-4174-94a1-ac517db7c92b.png)](https://cta-redirect.hubspot.com/cta/redirect/9311986/49160063-12ea-4174-94a1-ac517db7c92b)

- [Home](https://georgiaradiationtherapy.com/)
- [Locations](https://georgiaradiationtherapy.com/locations)
- [Cancer Education Blog](https://georgiaradiationtherapy.com/blog)

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