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  • Due to the volume of patients being referred to our center, the Autonomics Clinic should receive all of the following required documents within 90 days of the initial referral or the referral will be terminated and all associated documents discarded:
  1. Referral letter (For an example, click here)
  2. Referring provider information (name, specialty, address of practice, phone and fax numbers)
  3. Patient demographics (name, DOB, address, phone number, and insurance information)
  4. Three (3) complete sets of orthostatic vitals 
  5. One to three (1-3) office visit notes within 3 months of the initial referral

Please fax or mail these documents to:
Autonomic Dysfunction Clinic
Vanderbilt Heart & Vascular Institute
1215 21st Avenue South
Nashville, TN 37232
Phone: 615-322-2318    Fax: 615-936-8208
Phone: 800-288-5000, ext. 22318

  • Once we have received the referral, we will make one attempt to contact the referring provider to request any missing documents.
  • Once all items are received within the 90-day period, the providers will review all documents and determine whether the patient is an appropriate candidate and would benefit from being seen in the Autonomics Clinic.
  • If the patient referral is rejected, the referring provider will be notified with a brief explanation.
  • If the patient is accepted, our scheduler will contact the patient to schedule a consult appointment with any appropriate diagnostic testing.