PHYSICIAN REFERRAL FORM
If you are a physician and need to refer one of your patients to Benton Franklin Orthopedic Associates, then please use the form below. We will keep you informed of all treatment, tests and results regarding this patient in a timely manner. Please do not hesitate to call our office if you need further information at (509) 586-2828. This form is only to be completed by a referring physician or staff member. All information is encrypted and stored in a secure database – in compliance with HIPAA.