Please use the form below to submit your referral to Pittsburgh Sinus Centers. Someone from our office will be in contact with the referral in order to set up their appointment.
Rules and Conditions of the Family and Friends Referral Program:
- Fill out the above form in order to submit your referral (you must fill out an individual for each person).
- There is no limit to the number of referrals that can be submitted.
- A referral is considered completed when the person being referred has come to their first office visit (telehealth visits do not apply).
- Once the referral is completed, the referring person will receive a $50 Visa Gift Card (per completed referral) in the mail.
- Once the referral is completed, the person who has been referred will also receive a $50 Visa Gift Card.