Patient Referral

If you are a healthcare provider and would like to refer a patient to our practice, please fill out the form below to send a confidential message. All communication, including patient information, will be kept confidential and secure. 

 

We appreciate your interest in working with us and will respond to your request within 1-2 business days.

5930 Lovers Lane, Third Floor, Portage, MI 49002

Hours: Monday - Friday 10:30am - 6:00pm

Phone: (269) 381-6950 | Fax: +1(866) 898-9349