Patient Referral Form

Patient Referral Form

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Dear Physical Therapy and Chiropractic Providers,

At Arizona Sleep and Breathing, we work in close collaboration with DPT as well as Chiropractor who provides therapy in conjunction with balancing bites with neuromuscular treatment methods in our office! Physical therapy is an effective treatment for TMD.

Thank you for entrusting me with the care of your patients. It is always a pleasure to collaborate with you, and I appreciate your confidence in my ability to provide TMD treatment to your patients and clients. I am committed to ensuring that they have a positive experience and receive the highest quality care. I value our partnership and look forward to continuing to work together.

Please fill the downloadable referral form and fax to 520-299-1739, You may also scan and email to merchant@arizonasleepandbreathing.com, or submit the form online.

Download referral form                           Online referral submission