Please click on the link below to access the form that your doctor needs to complete and sign.  This is a printable PDF file.  You fill out your information, the referring physician fills out the yellow highlighted areas. You then need to bring this with you to your initial visit if you are covered under your automobile insurance policy for injuries sustained during an accident or are using your medical insurance coverage for your massage therapy.

PRESCRIPTION FORM REFERRAL

Tags: medically necessary massage therapy referral for White Dragon Therapies in Myrtle Creek Oregon, White Dragon Therapies in Myrtle Creek Oregon, White Dragon Therapies massage for MVA injuries referral form, White Dragon Therapies massage referral form
Filed under: Intake Forms