If this is an Emergency Referral please contact our office at (480) 653-8776.

To submit a referral, you have two options:

1) Download and complete the referral form PDF and fax back to (480) 653-8776.

2) Scroll down to the e-form below, fill it out, and click “Submit”.

Download OD Referral PDF

Download MD/PCP Referral PDF