Home
About Us
Services
Our Team
Penny Goudelock, PA-C
Beth Hewes, PA-C
Salman Kazim, MD
Heather Sanudo, ARNP
Referrals
Downloads
Contact Us
Home
About Us
Services
Our Team
Penny Goudelock, PA-C
Beth Hewes, PA-C
Salman Kazim, MD
Heather Sanudo, ARNP
Referrals
Downloads
Contact Us
Referrals
Urgent Requests:
For urgent matters, medication requests, or appointment needs, we kindly ask you to contact us via phone or text.
Referrals Accepted From:
Department of Labor and Industries
Patient and Employer Attorneys
Vocational Counselors
Medical Providers (including Attending Physicians)
Psychologists
Patients and Patient Families
Self-insured employers and Third Party Administrators (TPAs)
You can open the secure form by clicking on the link below.
Online referral form
Printable PDF referral form