top of page
What do we need for a referral?
First Report of Injury – if available. If not then please send as much demographic information as possible. We at least need the DOB, SSN and a contact phone number…although we have started files without them!
Signed Panel C42 with the choice of an authorized physician. If you need a panel, then we will provide you with a recommendation. We will follow up with the injured worker to obtain their choice and schedule the appointment as soon as possible.
Medical records if you have any available. We will obtain if you do not.
That is absolutely all we need to get started!
bottom of page