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We accept referrals in the following methods:

Fax: (661)281-2126


Online Referrals: HIPPA compliant option to fill and submit referrals directly through our website, no account setup needed! Please follow the yellow banner on the right side of the homepage after clicking HERE.

Please note that we do accept walk-in patients but appointments are strongly encouraged for shorter wait times.

To expedite referrals, please ensure to include the following medical records:

  • Valid Referral: provider signature, date, patient name, DOB, device type, left / right laterality, quantity, & ICD 10 code

  • Patient Demographics: patient name, DOB, address, phone, & applicable insurance details

  • Provider Notes: a copy of the physician’s notes from the date of the prescription

If you need more referral pads, please click HERE.


To download a printable referral click  HERE.

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