Referral requests are retrieved from this site several times daily. On weekends, you may want to submit any urgent requests by phone. There is no need to submit multiple requests for the same referral.

We do ask that you give us the courtesy of requesting your referral no less than 3 days prior to your specialist appointment. If you are an Aetna US Healthcare or Keystone Health Plan East member, there is no need to pick up your referral at Hatboro Medical Associates. The information will be sent electronically and will be available to your specialist within 3 days of your request.

Please fill in all information as completely as possible. Then click the SUBMIT button at the bottom of the page.

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Patient Information
First Name
Last Name
Middle Initial
Date of Birth
Phone Number
Reason for visit
Insurance ID#
Insurance Company
Referral Information
Specialist's Name
Specialist NPI Number
Date of Visit
Reason for Referralmore details
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Office Hours

  • Monday - Thursday 7:30AM - 9:00PM
  • Friday 7:30AM - 4:00PM
  • Saturday 8:00AM - Noon