Refer a Patient Form

Please fill out the following form to refer a patient to Barrington Orthopedic Specialists.

To view additional resources, please click here

Referring Office Contact Information
If you would like a confirmation of your patient's appointment, please provide your fax number.
Patient Information
If requested to be seen immediately, please call our office at (847) 285-4200.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
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