Neurosurgery Referrals

FAX to (650) 257-2979

Include Patient Info:

  • Insurance cards (front and back)
  • Reason for referral
  • Diagnoses and ICD-10 codes
  • Patient demographics
  • Copies of recent chart notes
  • Copies of CT and MRI reports

Include Your Info:

  • PCP name
  • Staff name
  • Your clinic/office phone number
  • Your clinic/office fax number
FAX to (650) 257-2979

Thank You for Referring Your Patient!

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