How It Works
Simple, Fast Referral Process
1
Submit the Form
Complete the online referral form below, or fax to (949) 550-1515. Include urgency level and relevant clinical history.
2
Send Records via Klara
Send insurance cards, prior imaging, and progress notes securely via Klara text to (949) 534-4000. Do not email PHI.
3
We Follow Up
Our team contacts the patient within one business day. A consultation report is sent to your office after the visit.
Online Referral Form
Submit a Referral
Please complete all required fields. For urgent or emergent cases, call the office directly at (949) 534-4000 after submitting.