NIH Clinical Center: NIH Clinical Center Referring Physicans

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For Referring Physicians

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For Your Patients

Are Clinical Studies for You?

Staying Involved: Your Role

Stay Involved with Patients You've Referred to the NIH Clinical Center.

The NIH Clinical Center is committed to keeping you informed about the patients you refer here to participate in clinical research studies. When a patient is accepted into a protocol, he or she is asked to identify practitioners who should receive ongoing medical updates. Patients provide written authorization for us to share this information. Please encourage your patients to list you as authorized to receive these updates.

Authorized practitioners will receive a report following the patient’s initial visit to the Clinical Center and periodic updates about the patient’s progress. The initial report will discuss preliminary findings and also will provide the referring practitioner with contact information for the patient’s NIH clinical team, including the attending physician and the branch chief of the Institute sponsoring the study in which the patient is enrolled.

Stay Informed

Help us keep in contact with you. If you refer a patient to a study here, having your most current contact information allows us to keep you informed about your patient.

Privacy Act Notification Statement

Collection of this information is authorized under 42 U.S.C. 241, 248 and 282. The primary use of this information is to help the National Institutes of Health Clinical Center remain in contact with you. If you refer a patient to a study at the Clinical Center, your most current contact information allows us to keep you informed of the medical treatment and care provided to your patient. This information may be disclosed to Clinical Center staff as well as referring and other designated physicians who receive medical information for continuing patient care upon discharge. Submission of this information is voluntary. However, if you choose to not provide your contact information, we may be unable to keep you informed about patients you referred for admission to the Clinical Center.

* Required fields:

First Name *	Required Field
Last Name *	Required Field
Organization
Business Address *	Required Field
City, State *	Required Field
Zip *	Required Field
Country *	Required Field
Business Phone
E-mail
Fax
NPI Number

I understand that by submitting this information, it will only be used to keep me informed about a patient I have referred for a study. Furthermore, I understand that the patient must designate me as an authorized provider to receive medical updates regarding his/her care while at the Clinical Center. *

Required Field

Page last updated: April 12, 2010