Refer a Patient

SHARP provides referral management services as required by the plan for the following employer plans and insurance companies. If you have a patient covered with one of these groups that needs a referral for the services listed for that group please complete a SHARP Patient Referral Form and fax to SHARP’s confidential fax number (870) 972-0036.

  • Arkansas Glass - SHARP Tertiary Providers, Out of Network Requests
  • Arkansas Methodist Medical Center - SHARP Tertiary Providers, Out of Network Requests
  • Lawrence Health Systems - SHARP Tertiary Providers, Out of Network Requests
  • St. Bernards Behavioral Health - SHARP Tertiary Providers, Out of Network Requests
  • St. Bernards Medical Center - SHARP Tertiary Providers, Out of Network Requests
  • St. Bernards Owned Clinics Group - SHARP Tertiary Providers, Out of Network Requests
  • St. Bernards Five Rivers - SHARP Tertiary Providers, Out of Network Requests

Refer a Patient

Fill out and return this form to make a referral for your patient.

Referral Form [DOC]