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For referring clinicians

Send the referral. We handle the rest.

Choose the referral type, then open the matching secure form. Each form collects scheduling details only; clinical records stay in the verified records route.

Ready to refer?Refer a Patient

Alternate submission

Prefer to fax?

Send the referral and any supporting clinical records from your secure fax system.

The online form collects scheduling details only. Do not paste records, imaging reports, or medication lists into it. Questions? Call your clinic.

Learn more about referrals and records

01

Two ways to refer

Medical offices use the Refer a Patient form. Attorneys and case managers referring an injured client use the Personal Injury Referral, which captures the letter of protection status for our team to review.

Prefer the phone? Call your clinic during office hours and the team will take the referral directly.

02

What helps us schedule the right visit

A clear reason for referral helps the receiving team understand the patient’s current problem and the question you want the evaluation to address.

  • Primary pain concern, symptom distribution, and duration
  • Relevant diagnoses, red flags, and functional limitations
  • Prior conservative care, procedures, and response
  • Current medications and clinically relevant health risks

03

Include useful supporting records

The practice can tell you which records are required for the planned visit. Commonly useful materials may include recent imaging reports, specialist notes, procedure records, discharge letters, and the current medication list. Fax them to 480-493-5336 or choose “Please request them from our office” on the form.