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Dear Referring Physician: Thank you for allowing Pacific Orthopaedic Associates to participate in the care of your patient. To ensure a productive first visit for your patient, we kindly request you provide our office and patient with the following information: * Health Insurance Carrier / IPA or Medical Group (if applicable) * Preliminary diagnosis * Doctor’s name with fax number. * Patient Information o Patient Name o Date of Birth o Address o Phone Number * X-Ray or Imaging Study, including MRI and/or CT Scan (if available) pertaining to your orthopaedic(s) condition. Please do not have the patient bring the X-Ray or Imaging study result alone, having the actual X-Ray or Imaging films allows our providers to conduct a comprehensive evaluation of your patient’s condition. We appreciate you taking the time to refer your patient to us. Sincerely, Pacific Orthopaedic Associates Providers & Staff |
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