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Important Information for UnitedHealthcare Medicare Advantage Members in Rhode Island

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  • The Center for Cardiac, Pulmonary, and Vascular Fitness
    • Cardiac Rehabilitation Program
      • Heart Failure Patient Services
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      • Cardiac Patient Back at the Altar and On the Ice
    • Educational Resources for Patients
      • Helping a Loved One with Heart Health
    • Referral Forms for Physicians

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  1. Centers And Services
  2. The Center For Cardiac, Pulmonary, And Vascular Fitness
  3. Referral Forms For Physicians
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Referral Forms for Physicians

If you are a referring physician, please use the appropriate form below to refer your patient to one of our programs. They are all in the form of a PDF.

Referral Forms for Programs at Our Providence Location

  • Cardiac Maintenance Program
  • Cardiac Rehabilitation Program
  • Diabetes Outpatient Education
  • Health For Life Program
  • Pulmonary Rehabilitation and/or Respiratory Services

Referral Forms for Programs at Our Newport Location

  • Cardiac Rehabilitation Program
  • Diabetes Outpatient Education
  • Pulmonary Rehabilitation and/or Respiratory Services
  • Risk Factor Reduction Program
The Center for Cardiac, Pulmonary, and Vascular Fitness
  • Cardiac Rehabilitation Program
    • Heart Failure Patient Services
  • Intensive Cardiac Rehab Program
  • Vascular Rehabilitation Program
  • Pulmonary Rehabilitation Program
  • Peripheral Artery Disease (PAD) Rehabilitation Program
  • Lowering Your Risk of Cardiovascular Disease
  • Prevention Programs
  • Support Services
  • Our Facilities
  • Patient Stories
    • Cardiac Patient Back at the Altar and On the Ice
  • Educational Resources for Patients
    • Helping a Loved One with Heart Health
  • Referral Forms for Physicians

Brown University Health, Rhode Island's first health system, was founded in 1994 by Rhode Island Hospital and The Miriam Hospital. A comprehensive, integrated, academic health system with The Warren Alpert Medical School of Brown University, Brown University Health's present partners also include Rhode Island Hospital's pediatric division, Hasbro Children's; Bradley Hospital; Newport Hospital; Gateway Healthcare; Saint Anne's Hospital; Morton Hospital; and Brown Health Medical Group.

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