For the Referring Medical Provider


PLEASE CONTACT US IN PERSON TO INFORM US OF THE REFERRAL AT (831) 440-7653

All Doctor referrals should be faxed or emailed to us via:

FAX: (831) 222-3053

EMAIL: INFO@COMMUNI-QI.COM

WE TAKE PRIVATE INSURANCE, WORKER’S COMP CASES & PERSONAL INJURY CASES

PLEASE INCLUDE THE PATIENTS NAME, INSURANCE CARRIER, MEDICAL ICD-10 DIAGNOSIS THAT THEY ARE BEING TREATED FOR.

FOR WORKERS COMP, PLEASE INCLUDE THE ACUPUNCTURE AUTHORIZATION LETTER & ADJUSTER, PRIMARY PHYSICIAN NAME & ALL CONTACT INFO

FOR PERSONAL INJURY, PLEASE INCLUDE THE NAME OF THE PATIENT, CASE #, INSURANCE CARRIER, LAWYER AND ALL CONTACT INFO. WE ALSO ACCEPT CASES THAT ARE ON A MEDICAL LIEN