REFERRAL FORM بطاقة إحالة لقد تمت إحالتك إلى مركز أردنز الطبي.You’ve been referred to Ardens Medical Center-Dubai!بالتعاون مع عيادتك, نحن معًا ملتزمون بضمان حصولك على أعلى معايير الرعاية Together, with your clinic, we are committed to ensuring you receivethe highest standards of care, with dignity, compassion, and confidentiality at every step Date: Form No: Patient Information Name Phone Number Date of Birth Referred by Contact Number Reason for referral Mental Health Substance Use / Detox Other (Please specify): For more information, call +971 4 523 2999 ✉️ Submit Referral