Referring Offices

Click on the form below. All forms are in the pdf format, fillable using Adobe Reader. You may submit the forms using one of the following:

  • Send us the completed form as an attachment to your email, to, OR
  • Send us the completed form via fax to 559-322-2056, OR
  • Print out and have patient bring to the Appointment.

Referral Form

Print instructions and map for patient

Please email radiographs to

You can also submit a digital referral slip by clicking here..