Fellow Practitioners
Welcome! On this page you will find our referral form and tincture request form.
To refer a patient or request a tincture, please fill out the form and fax back to us at
1360-838-4641
TINCTURE REQUEST
Click the picture to the left to open it in a new window. Save and print the image, fill out the information and just fax back to us!
REFERRAL FORM
Same as above! Click the picture to the left to open it in a new window. Save and print the image, fill out the information and just fax back to us!