Community Provider Information
Referring a patient to CWCC
There are several ways to refer a new patient to our practice.
Contact our Direct Provider Line - (706) 438-2000 to speak with our Intake Coordinator, Mayra Trevino. She will collect all information and schedule your patient with one of our providers.
Fax your referral form and patient information to (706) 257-1719.
Email your referral form and patient information to
Providers may submit an electronic submission - New Patient Referral
Requesting Medical Records
There are several ways to request records from our practice.
Complete and submit a signed Authorization to Release Protected Health Information via fax or email.
Fax number: (706) 257-1719
Please contact our Direct Provider Line with any questions at (706) 438-2000