Refer a Patient to Knights of Columbus
After receiving your patient’s referral, the family will be called and/or will receive a confirmation letter. Please inform the family that the wait list is lengthy, and they will again be called when it is time to schedule. If the child receives an appointment elsewhere while on the wait list, please contact us so they can be removed from the list.
In addition to the form below, we ask that the patient’s insurance card and the PCP’s most recently well visit notes be faxed to Knights of Columbus. If you have any questions, please call us at 314-577-5609.