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Children's Hospital at Dartmouth Hitchcock (CHad)
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Referral Forms

For more information on how to refer a patient, refer to the Dartmouth-Hitchcock Referring Providers website.

If you have questions or are having access problems, please call the Physician Connection Center toll free at (866) 346-2362.

CHaD is happy to offer one standard referral form for all pediatric specialty services with one exception. For referrals for sleep studies in Pediatric Neurology in Manchester, please use the specific form for this as noted below.

Downloadable referral forms

For additional forms, visit the Referral Forms page of the DHMC Referring Providers website.