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
- 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.
Pacific Orthopaedic Associates Providers & Staff