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  • Workers' Compensation Referral

    Direct Line (623) 683-8100 | Fax (480) 962-0590
  • Requested Appointment Information

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  • Note: Records must be faxed to our office no later than 48 hours prior to appointment. If records are not received, appointment may be rescheduled until records are received.

  • Patient Information

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  • Employer Information

  • Insurance Information

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  • APPOINTMENTS WILL BE SEEN WITHIN 24 HOURS AND IN SOME CASES THE SAME DAY

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