Refer a Patient

Refer by Phone

Please call (281) 515-8120 and share the following:

Patients insurance plan.
Patients medical history.
Patients active medication list.
Please have the patient bring in recent labs and any imaging available.

Refer by Email Or Fax

Fill out the form below and email to info@epicfootandankle.com or fax to (949) 561-5447

Please have the patient bring in complete medical history including medication list, recent lab results, and any available imaging.

ONLINE REFERRAL FORM * Required Fields

First name *

Last name *

Phone Number *

Email *

Date of Birth *

Choose gender *

Reason for visit *