For Referring Physicians & Providers

Physician Referral
to Precision Spine & Joint

Use this form to refer a patient for diagnostic neuromusculoskeletal evaluation with Dr. Andrew Bishara, DC. We confirm receipt within one business day and contact the patient directly to schedule.

Scheduling

Typically within the same week

Insurance

Most major plans accepted

Feedback

Evaluation report sent to you

Clinical Scope

Conditions We Evaluate & Treat

Dr. Bishara provides diagnostic-first evaluation of neuromusculoskeletal conditions. Referrals are appropriate for patients with spine, joint, disc, or nerve-related complaints that have not responded to initial management or that require structured diagnostic workup.

✓

Spine & Disc Conditions Disc herniation, disc bulge, lumbar & cervical radiculopathy, degenerative disc disease, stenosis

✓

Joint & Extremity Pain Shoulder, hip, knee, wrist, and ankle dysfunction; mechanical joint pain; post-surgical rehab evaluation

✓

Headache & Cervicogenic Pain Cervicogenic headache, tension-type headache, occipital neuralgia evaluation and conservative management

✓

Nerve-Related Complaints Sciatica, peripheral neuropathy workup, upper/lower extremity radicular symptoms, EMG coordination

✓

Post-Accident & Trauma Motor vehicle accident injuries, whiplash, soft tissue trauma — LOP accepted for PI cases

✓

Imaging Review & Coordination MRI, CT, and X-ray correlation with clinical findings; imaging ordered when medically indicated

Referral Process

How the Referral Process Works

Submit This Form

Complete the form below with your patient's information and the reason for referral. You'll receive a confirmation, and the patient will be contacted within one business day to schedule.

Comprehensive Evaluation

Dr. Bishara performs a thorough neuromusculoskeletal evaluation — orthopedic and neurological examination, imaging review and correlation, and differential diagnosis workup.

Report Back to You

A complete evaluation report including findings, diagnosis, and care plan is available to the referring provider. Ongoing communication maintained throughout the course of care.

Submit a Referral

Physician Referral Form

Please complete all fields. The patient will be contacted directly to schedule their evaluation. An evaluation summary will be sent to the referring provider upon request.

Referring Physician Information

First Name *

Last Name *

Specialty *

Practice / Hospital Name

Office Phone *

Office Fax

Email Address

Office Contact Person

NPI Number (optional)

Patient Information

Patient First Name *

Patient Last Name *

Patient Date of Birth

Patient Phone *

Reason for Referral / Chief Complaint *

We confirm receipt within one business day and contact the patient directly to schedule their evaluation.

Questions?

For urgent referrals or to speak with our office directly, please call during business hours.

(XXX) XXX-XXXX
Mon–Fri · 9AM–6PM CT

Insurance

Most major insurance plans accepted, including Medicare, Blue Cross, Aetna, Cigna, UnitedHealthcare, and more. LOP accepted for qualified PI cases.

View insurance information →

Attorney Referrals

If you are a personal injury attorney looking to refer a client, please use our dedicated attorney referral form.

Attorney referral form →

Physician Referralto Precision Spine & Joint