If you are a referring provider, please fill out the Physician Referral Form and fax it to us at the number provided. Our care coordinator will review the referral and contact your office to ensure your patients benefit from appointments with the right Kaizen specialist to meet their needs.

PHYSICIAN REFERRAL FORM PDF

PHYSICIAN REFERRAL FORM RTF

I am so grateful for the entire team at Kaizen. My son has a TBI and we have never received such stellar treatment. Dr. Ahmed has put together a team of professionals like no other. Thank you for all you have done and continue to do for my family!

LISA
TRAUMATIC BRAIN INJURY PATIENT’S PARENT