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Referrals

Questions about referrals can be answered by our referral coordinator Jacque Bounds at 602-263-1962.


Many insurance companies require referrals. A referral requires that one of our doctors has seen your child for the problem and wants you to see a specialist for further care. The office will give you the necessary information about the specialist usually during your visit. You may then make the appointment with the specialist and call back Jacque with information about the appointment.

Our insurance coordinator Jacque will need the following information to complete your referral. You may call Jacque with this information or submit via email below.

  1. Patient name and date of birth
  2. Patient telephone number
  3. Patient insurance company
  4. Appointment date and time
  5. Specialist name, telephone number, and location of appointment

 

FAILURE TO CONTACT JACQUE WITH THE ABOVE INFORMATION 48 HOURS PRIOR TO YOUR APPOINTMENT COULD RESULT IN YOUR APPOINTMENT BEING CANCELLED OR YOU HAVING FULL FINANCIAL RESPONSIBILTY FOR THE SERVICES PROVIDED BY THE SPECIALIST.

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Referral Form