Pacific Orthopaedic Associates Pacific Orthopaedic Associates : (626) 282-1600

Referring Physicians

Dear Referring Physician:

Thank you for allowing Pacific Orthopaedic Associates to participate in the care of your patient.

To ensure a productive first visit for your patient, we kindly request you provide our office and patient with the following information:

  • Health Insurance Carrier / IPA or Medical Group (if applicable)
  • Preliminary diagnosis
  • Doctor’s name with fax number
  • Patient Information
    • Patient Name
    • Date of Birth
    • Address
    • Phone Number
  • X-Ray or Imaging Study, including MRI and/or CT Scan (if available) pertaining to your orthopaedic(s) condition. Please do not have the patient bring the X-Ray or Imaging study result alone, having the actual X-Ray or Imaging films allows our providers to conduct a comprehensive evaluation of your patient’s condition.

We appreciate you taking the time to refer your patient to us.

Sincerely,

Pacific Orthopaedic Associates Providers & Staff

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