Physicians – Cleveland Clinic Abu Dhabi

Physician Referral Form

Please complete the simple form below, including as many details as possible, in order to help us identify a specialized physician to meet your patient’s specific needs.

Urgent Transfers

Contact our call center on 800 8 2223 and ask for ‘Hospital Transfers’.

If you’re calling from outside the UAE, please call our Contact Center on +971 2 659 0200

Please note, our direct HTC number is for medical personnel only.

First Name

Last Name

Phone Number

Email address

Organisation Name

Please ensure that the following information is provided exactly as it appears on the patient’s Emirates ID or passport.

First Name

Last Name

Date of Birth

Gender

Please note, we are unable to accept patients under the age of 14, with the exception of our Eye Institute and Emergency Medicine Institute.

Phone Number

Email address

When Does The Patient Needs To Come In?

Upload any supporting information (eg: medical report)

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Physician Referral Form