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International Referrals

Our International Patient Services team will review your provided information and the child's medical records to recommend the best treatment plan for the child at Cook Children's Health Care System.

To help us more fully understand the patient's needs, please complete the international referral form below and return it to International Patient Services. If you need assistance or have questions, our staff is here to help at 01-682-885-INTL (01-682-885-4685).

Please email the completed form to, or fax the form to Cook Children's International department at 01-682-885-2557.

Visit our International referrals page Referral form - English Referral form - Spanish

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