Referring Doctors

 How To Refer

Referral Form

1. Scheduling Your Patient - In order to best serve your patient, we suggest scheduling them with our office as they are finishing their visit with you. This creates a simple, worry free process for the patient and allows us to offer them the best appointment option.
2. Completing The Referral Form - The referral form is a helpful item for both Dr. Thanik and our team. It gives us the opportunity to properly prepare for your patient’s visit with us to ensure that we can offer them a thorough exam. We ask that you fill out all pertinent information on the referral form. If a question does not apply, feel free to skip it. We are grateful that you take the time out of your busy schedule to provide us with this helpful information.
3. Sending Over Patient Information - We kindly request that you share any pertinent patient information with us prior to their scheduled visit. This includes the following: Patient Name, Date of Birth, Contact Information and Insurance Information. In addition to patient information, we also ask that you share the completed referral form and any radiographs. This ensures that we are adequately prepared to care for your patient.

If you have physical copies, feel free to fax them to us at (503) 966-3780.