Fletcher Allen, a Vermont university hospital and medical center, serves all of
Vermont and the northern New York region. Located in Burlington, Fletcher Allen is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont.
Community Agency Provider Referral Form
This referral form is for Fletcher Allen's community partners that have worked with our Community Health Team (CHT) and have a client that might benefit from the services of the CHT. The Community Health Team will inform the client’s primary care provider and we will let you know how we will proceed.
If you have questions, please contact us at (802) 847-1601.
Please download and fill out the form and return it via email to email@example.com or send via fax or postal mail to:
Community Health Team
Fletcher Allen Health Care
128 Lakeside Ave, Suite 106
Burlington, VT 05401
Phone: (802) 847-1601
Fax: (802) 847-6545
|Community Agency Provider Referral Form||Download PDF|
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