Refer a Patient


Thank you for choosing OhioHealth Gastroenterology Physicians for your patient. Please print, fill out and fax our New Patient Referral Form to request a consultation or procedure for your patient with Dr. Levin or Dr. Kapoor.

For your convenience, a "fillable PDF" version of our New Patient Referral Form is also provided. An updated version of Adobe Acrobat software may be needed to type information into this form and save to your computer.

Phone and fax number for both locations:
Phone: (614) 544-1891
Fax: (614) 544-1890

If you wish to email your referral to our office, save your completed form to your computer then please email to Elizabeth.Leonard@ohiohealth.com. After emailing, please call our office at (614) 544-1891 to ensure your referral form was received.