Medical Rehabilitation Consultants
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Phone: 509-328-9700

Fax: 509-328-9777








Request for Medical Case Management

  • Requester Information

  • Please choose a Case Type

    Outreach Team Referral

    MSW Only Referral

    COPE Referrals

  • Patient Information

  • Provider Information

  • Format: MM/DD/YYYY Separate Multiple Dates with a Comma (,)

  • Leave blank if only 1 Physician

  • Consultation Information

  • File Types: DOC, DOCX, JPEG, JPG, PDF, or TXT

    Size Limit: 10MB

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