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Cast Clinic Referral Form - Dell Childrens Medical Center of Central

Cast Clinic Referral Form - Dell Childrens Medical Center of Central 2026

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4.3 out of 5

43 votes

The document is a referral form for the Marnie Paul Specialty Care Center, specifically for the CAST Clinic. It includes sections for patient information, referring physician details, diagnosis codes, insurance information, and specific medical history requirements. The form emphasizes the need for complete information to avoid rejection and outlines conditions under which patients must be directed to Dell Children’s Emergency Department.

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Click ‘Get Form’ to open the Cast Clinic Referral Form in the editor.
Begin by filling in the 'FROM' section with your name, phone number, and fax number. This information is crucial for communication.
Complete the patient details: enter the patient's name, date of birth (DOB), and contact information including their address.
In the 'Referring Physician' section, provide the full name and credentials (M.D. or D.O.) of the referring physician. If there is a different primary care physician, include their details as well.
Specify the diagnosis and include relevant CPT or ICD9 codes. Clearly state the reason for referral and select the appropriate insurance type (HMO or PPO).
Fill out any additional required fields such as DOI, mechanism of injury, and whether films are available. Ensure all sections are completed to avoid rejection.
Finally, have the referring physician sign and date at the bottom of the form before submitting it via fax to ensure proper processing.

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Versions	Form popularity	Fillable & printable
2013	4.3 Satisfied (43 Votes)

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Who owns Dell Childrens Medical Center?

Messer was previously the head of Dell Seton Medical Center, Austins trauma center and safety net hospital. Both are owned by Ascension Texas. Messer, 39, has been spending his days walking the halls of both Dell Childrens main campus in East Austin and its North Austin hospital.

Is Dell Childrens part of Ascension?

Dell Childrens is part of Ascension, the largest nonprofit health system in the U.S. and the worlds largest Catholic health system. Through this affiliation, Dell Childrens delivers nationally recognized, mission-driven care to patients across Central Texas and beyond.

How old is Dell Childrens hospital?

Dell Childrens Medical Center opened on June 30, 2007. Dell Childrens Medical Center is the only dedicated freestanding pediatric facility in the region.

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How big is Dell Childrens hospital?

Dell Childrens Medical Center of Central Texas is a pediatric acute care hospital located in Austin, Texas. Serving a 46-county area and beyond, the hospital has 262 beds with an additional 72 beds available beginning fall 2022.

Who owns Dell Medical Center?

It is on land owned by the University of Texas at Austin. Central Health leases the land, and in turn the owner and operator of the hospital building, Seton Healthcare Family, subleases it from Central Health. Dell Seton is a Level 1 Trauma Center serving 11 counties in Central Texas.

Is Dell Childrens a non-profit?

Designated as a 501(c)(3)

Cast Clinic Referral Form - Dell Childrens Medical Center of Central 2026

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