Primary Care to Longevity Medicine Clinic Referral Form

Streamline Patient Referrals to Longevity Medicine Specialists

Primary care providers are increasingly recognizing that their patients want more than disease management—they want to optimize healthspan, understand their biological age, and explore evidence-based interventions that support healthy aging. This Primary Care to Longevity Medicine Clinic Referral Form makes it simple to connect patients with specialized longevity clinics offering biological age assessments, senolytic therapy, metabolic optimization, and personalized age-reversal protocols.

Built for primary care physicians, internists, and family medicine practices, this Paperform template captures all the clinical context longevity specialists need—chief complaints, current medications, relevant lab values, and health optimization goals—in a structured, professional format that integrates seamlessly into modern healthcare workflows.

Why Paperform for Healthcare Referrals?

Paperform is trusted by healthcare providers for secure, compliant patient communication. This referral template uses conditional logic to tailor questions based on the patient's health profile, ensuring you collect relevant information without overwhelming referring physicians. With SOC 2 Type II compliance, encrypted submissions, and integrations with EMR systems via Stepper (stepper.io), you can automate referral routing, patient notifications, and follow-up coordination—keeping the entire care team in sync.

Whether you're a longevity clinic building a referral network or a primary care practice looking to offer cutting-edge wellness pathways, this template helps you deliver a modern, coordinated experience that reflects the future of preventive medicine.