The AGS Foundation for Health in Aging - Public Education

The FHA Physician Referral Service

If you would like a list of physicians in your area who are sensitive to the special health care needs of older adults, please submit your request online by completing the form below. Due to the high volume of requests, it will take at least two to three weeks for this information to reach you by mail. At this time, it is not possible for us to fax or email this information to you.

All physicians participating in our referral service are members of the American Geriatrics Society and are board-certified in either Family Practice (FP) or Internal Medicine (IM). Many have also acquired additional training necessary to obtain the Certificate of Added Qualifications in Geriatric Medicine (CAQGM). Please be aware that a referral from us does not represent an endorsement by the AGS Foundation for Health in Aging or American Geriatrics Society of the services of the physician.

You may also conduct a search for board-certified geriatricians at the following web sites:

American Board of Family Practice
American Board of Medical Specialties
American Medical Association

Physician Referral Request Form

Name:

Email:

Street Address:

City:

State:

Zip:

Area Code and Phone Number (optional):

State(s) for the area in which physician referrals are being sought (up to 3 states):
State 1:
State 2:
State 3:

For whom is this referral requested:
Self
Spouse
Parent(s)
Grandparent(s)
Friend
Other:

Your Age:

Your Gender:
Male
Female

Are you a health care professional?
Yes
No

How did you learn about the FHA and this referral service?
TV
Radio
Newspaper/Magazine
Internet
Other:

Message:

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