REFERRAL AND TRANSFER FORMS

You can download a printable copy of our referral and transfer forms and fax the completed forms to our Durham hospital at 919-403-3339 and to our Holly Springs hospital at 919-887-6911 or you can submit your referral or transfer using the online submission forms below. 

Please note that online submissions are checked daily at 9am, 2pm and 6pm.  If you have an urgent case that requires a more immediate response, please call our Durham hospital at 919-489-0615 or our Holly Springs hospital at 919-973-5620 to inform us that you have submitted an online Transfer or Referral Form.

TVRH Durham logo

Printable forms

tvrh holly springs logo

Printable forms

 

Online Forms

Online Forms