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(704)734-5223


Hours: 8:30 AM - 2:30 PM; Mon - Fri
Saturdays, twice a month

Referral Form

Physicians may download referral form, complete, and fax to NCS at 704-734-0662. Please attach a copy of the following:

  • Most recent labs (including lipid profile)
  • List of diagnosed medical conditions and related ICD-9 codes
  • List of current medications
  • Copy of complete (front and back) growth chart (if applicable)

Click here to download referral form in PDF format for printing.