Sending a referral from a healthcare professional’s office

When referring a patient to California Spine Diagnostics, please fax the following information to (415)600-7835:

1.       Referring physician or healthcare professional and contact information.

2.       Patient’s name, address, phone numbers, date of birth, social security number, and copy of insurance card.

3.       For worker’s compensation patients, include a written authorization from the insurance carrier, claim number, employer at time of injury, date of injury, and adjuster’s name and contact information.

4.       Medical services you would like us to provide, including consultation and/or procedures.

5.       Diagnostic imaging reports, current medical records, MRI, CT, or X-ray report if available.

We will contact the patient upon receiving the referral and proper authorizations.