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Now Taking Physician Referrals

Transplant ÈËÆÞÖгöÊÓƵ is here to assist community physicians and specialists with consultation and referral services.To refer your patient, please fill out the information below and click on "Submit". You will receive a response within one business day.

Please be aware, we can only respond to your request during normal business hours, 8 am–5 pm, Mon–Fri.

Appointment/Evaluation

To make an appointment for a heart transplant evaluation at U of U ÈËÆÞÖгöÊÓƵ, call 801-585-5122 or 800-824-2073. Before scheduling your appointment, we will check your insurance coverage to make sure the cost of the evaluation is covered.

Our team also will request medical records from your cardiologist to help plan your visit.

Contact Us

Phone: 801-585-5122
Toll-free: 1-800-824-2073 Ext. 53693
Fax: 801-213-3956
Email: Heart Transplant Team

Heart Transplant Referral Form

Patient Information

Gender

If you selected 'Other' for patient gender please specify how the patient identifies

Patient's Address

Patient Diagnosis

Referring Physician Information

Referring Office Address
Call 801-585-5122 or