Patient Referrals

If you have a patient who could benefit from Knoxville Institute of Dermatology’s experience, our physicians are ready to help provide the best care possible.

Refer your patients conveniently and with confidence.

One of our missions at Knoxville Institute of Dermatology is to help physicians take the very best care of their patients. We are devoted to your patients and we look forward to providing them with advanced and highly personalized skin care.

Referral Phone Number

865.450.9361

Referral Fax Number

865.450.9362

Appointment Request Form
Moh's Surgery Consultation Request Form

Appointment Request Form

Appointment Request Form

Patient Name(Required)

Date of Birth(Required)

Insurance(Required)

Sex(Required)

Address(Required)

Street Address City State ZIP Code

Primary Phone(Required)

Secondary Phone

Chief Complaint / Reason for Referral

Preferred Location:

Knoxville: 6516 Kingston Pike, Knoxville, TN 37919

Lenoir City: 1018 Highway 321 N, Lenoir City, TN 37771

Tellico Village: 202 Dohi Dr, Loudon, TN, 37774

Morristown: 3001 W. Andrew Johnson, TN 37814

Referring Physician

Referring Physican Phone

Fax

Moh's Surgery Consultation Request Form

Mohs / Surgery Consultation Request Form

Send your referral to us securely.

Use the form below to submit any referral documents or photos electronically.

Patient Referrals

Refer your patients conveniently and with confidence.

Referral Phone Number

Referral Fax Number

Appointment Request Form

Moh's Surgery Consultation Request Form

Appointment Request Form

Appointment Request Form

Moh's Surgery Consultation Request Form

Mohs / Surgery Consultation Request Form

Send your referral to us securely.