Prior to completing the form below, please click here to review our Neurosurgeons by area of specialty and requirements for each.
Our physicians see patients at The Kirklin Clinic of UAB Hospital, 2000 6th Avenue South – 2nd Floor Birmingham, AL , Medical West, 995 9th Ave SW, Prof Office Bldg Suite 103, Bessemer, AL (Dr. Renee Chambers ONLY), and UAB Greystone, 7500 Hugh Daniel Dr., Suite 200, Birmingham, AL 35242 (Dr. Staner ONLY)
All new patient referral packets require a copy of the patient’s insurance card and photo ID.
Please fax all records to 205-934-6507.