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Knoxville Dermatology Group - Knoxville Dermatology Group

West KnoxvilleClick for Directions
SeviervilleClick for Directions
865-690-9467
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    • General Derm Referral
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Physician Referral

Does your patient need a dermatologist? WE’VE GOT YOUR BACK. And your patient’s back, front, arms, legs, neck, head and feet.

Refer to Knoxville Dermatology Group and you’ll never look back. In fact, you’ll look forward to discussing your patients and their cases directly with our board-certified dermatologists. By taking advantage of our accessibility and convenience, you’ll watch your patient satisfaction rates rise. Your patients will enjoy the unique combination of personalized care and proven, advanced clinical expertise offered by Knoxville Dermatology.

To refer a patient, please either complete and submit the form below or print, complete and fax the Patient Appointment Request Form to 865.205.5598.

If you are looking to refer a patient for Mohs Surgery please click here.

Our Offices
West Knoxville
Sevierville

Please be sure to submit or fax a unique form for each individual patient you are referring.

    Patient’s Name*

    Date of Birth - DD/MM/YEAR*

    Address*

    City*

    State*

    Zip*

    Insurance*

    Language Translator Needed (Please Specify):

    Patient Phone Number (Home or Cell)*

    Desired Appointment Day

    Desired Appointment Time

    Desired Appointment Location*

    Referring Provider Name*

    Referring Provider Phone Number*

    Provider Email*

    Referring Provider Fax Number*

    Reason for Appointment*

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    Search Knoxville Dermatology

    • Pay Online
    • About Us
      • Our Team
      • Employment
    • Services
      • Our Services
      • TeleHealth Visits
      • Patient Resources
      • Patient Portal
      • Glossary
    • Skin School Blog
    • Our Medi-Spa
    • Contact Us
    • Physician Referral
      • General Derm Referral
      • Mohs Surgery Referral
    • Patient Portal
    • Pay Online
    West Knoxville123 Fox Road
    Knoxville, TN 37922
    Sevierville 657 Middle Creek Road
    Sevierville, TN 37862
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