Inclusion Criteria:  Healthcare worker inclusion criteria:  work at one of three participating clinics as a provider or scheduler/referral coordinator  Patient inclusion criteria:  primary care provider is participating in the study develops a diabetic foot ulcer  Exclusion Criteria:  Healthcare worker exclusion criteria:  insufficient overlap between providers and schedulers, as determined by the clinic manager, such that it would be unlikely a potentially eligible patient could be seen by a participating provider and assisted by a participating scheduler for specialty referral in the same visit  Patient exclusion criteria:  receiving palliative care such that referral to urban centers for aggressive limb salvage would be inappropriate, as assessed by patient PCP insurance does not cover referral to the University of Wisconsin's specialty clinics unable to provide written informed consent