Physician Referral Form

Need a Doctor?

If you would like assistance in finding a provider, please send us an email. Please include the following information:

Provider specialty.
Preferred location.

We’ll also need your contact information:

First and last name.
Whether you’d like to be contacted by email or phone.
Email address and/or phone number.

Please don’t include any personal health information.

We will respond between one to three business days.

You can also check Samaritan’s online provider directory. Please call 911 if you are experiencing a medical emergency. Samaritan also offers several walk-in and urgent care options depending on the level of care and urgency of the care you need for non-life threatening medical issues.