Referral Form

Connecting you to the right specialist

Our team at the Patient and Provider Engagement Center (PEC) ensures that patients get the proper care when they need it most – and simplifies the referral process along the way. We help providers and clinical staff identify a specialist based on a patient’s unique needs and location. We also help patients find the right specialist and schedule appointments.

Minimum of 5 digits.
Please note we will do our best to accommodate your request as soon as possible, taking into account physicians’ availability and insurance verification.

If medical records are available, please fax to the Referral Line Specialist (1-425-276-3214) prior to the confirmed appointment.

For Physicians and staff

If you are a physician or physician staff, please complete this section