Submit a Referral

To our Referring Providers: If this is an emergency referral, please contact our office .

To submit a referral, you have two options:

Scroll down and complete the webform below, then click “Submit” when completed. Please also fax any relevant visit notes to 623-932-2668.

OR

Download the referral form here, fill out and fax form and any relevant visit notes to (623) 932-2668.