Referral info for Providers

Attention Referring Providers,

We will resume accepting referrals effective April 1, 2026. 

(We are working toward OCEAN REFERRAL SYSTEM. We will advise when this has been implemented.)

Dr. Langley does not accept referrals for Vasectomy.

Please review the following requirements carefully. Referrals that do not meet these criteria will be returned without processing.

Referral Requirements

􀁸 The attached referral form must be used. Referrals submitted on alternate forms will be returned. (Referral sheet faxed to offices January 2026)

􀁸 Referrals must be fully completed.

􀁸 Referrals must include complete patient demographics, including:
o Full mailing address
o Email address
o Telephone number(s)

Appointment Confirmation

􀁸 Patients must confirm their appointment a minimum of seven (7) days prior to the scheduled date.

􀁸 If a patient does not confirm, the appointment will be cancelled until we are able to confirm that the patient is aware of and able to attend.

Diagnostic Imaging and Laboratory Work

􀁸 Failure to complete required diagnostic imaging and/or laboratory work prior to the appointment will result in cancellation.

􀁸 The appointment will remain cancelled until all required testing is completed.

Missed Appointment Fees

􀁸 Missed initial consultations or procedures: $100 fee, payable prior to rebooking.

􀁸 Missed follow-up appointments: $50 fee, payable prior to rebooking.

Patient Notification Process

􀁸 Patients will receive an initial consultation letter as their first notification (when time allows).

􀁸 Patients will also receive an email and/or text message.

􀁸 A phone call may be made if prior contact attempts are unsuccessful.

􀁸 Once an appointment is confirmed, no further reminders will be sent unless the appointment is changed.

􀁸 It is the patient’s responsibility to track their confirmed appointment.

Provider Notification

􀁸 Both the referring provider and the patient will be notified of the initial consultation approximately 8–10 weeks in advance.

􀁸 The referring provider will receive the same correspondence that is mailed or emailed to the patient.

􀁸 This correspondence clearly outlines all patient requirements.

Thank you for your cooperation.

Sincerely,
Chatham Urology
Dr. Langley’s Office