Medical Rehabilitation Consultants
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Welcome to the MRC Secure Web Portal

Phone: 509-328-9700

Fax: 509-328-9777

Virtual Therapy Program

Referral Request Form

  • Patient Information

  • New Patient


  • Physical Therapy

    Occupational Therapy

    Speech Therapy

  • Please check ALL that apply

    iPhone / iPad


    Windows Laptop or Desktop (with audio/video capabilities)

  • Primary Insurance Information

  • Secondary Insurance Information

    (Leave blank if no secondary insurance)

  • Guarantor Information

    (If different from patient or patient is younger than 18 years old)

  • Is Direct Access to Therapy being utilized?

  • Yes


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