Please welcome our newest dermatologists, Dr. Cory Pettit and Dr. Dan Flood, who joined COSC this year!


Referral Form

Please note: Dr. Carl Allen sees patients in consultation only. He does not perform biopsies. If you schedule with him, and the patient needs a biopsy, the patient will have to reschedule with Dr. Ashleigh Briody for this procedure.

Please fill out the form below or download the referral sheet and fax to (614)794-4294

    Patient Birth Date:


    (Please provide a copy of medical insurance card, front and back. Please note that COSC is not a provider for any Medicaid.)


    Referral Information


    Referring Physician Information