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Referrals Forms
The sincerest compliment that our practice can be given is a referral from another healthcare provider.
Who to Contact?
Any questions or concerns with referrals please contact us at (559) 713-6461 or vapt@vaptpc.org
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Fax cover or cover sheet with appropriate
clinic contact information. -
MD Order
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Face Sheet
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Physical and History with appropriate Diagnosis
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Insurance Information
Take Note:
Please complete appropriate referral form and return with Demographics and History . Referrals can be faxed to(559) 713-6012 or emailed to vapt@vaptpc.org
Accepted Insurance
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Accepted Insurance For Workers' Comp
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