Referral Checklist

By referring patients requiring wound care services to our team, we can work collaboratively to enhance their recovery process.
Once you have identified a potential patient appropriate for consult/evaluation and treatment, you must submit the following documentations.

We only need a few pieces of required documentation to start processing a referral.

  1. Face sheet/Patient’s demographics (Required)
  2.  Signed physician/PA/NP order (Required)
  3.  Insurance information (Required)
  4.  Include any family members who should be contacted for appointment scheduling (Optional)

OTHER HELPFUL DOCUMENTATION

This information is extremely helpful and allows our team to more efficiently process the referral.

  • Wound Photos
  • History and Physical
  •  Any recent progress notes, if available
You can choose how to submit the documents whether through our email, fax, or online referral portal.
Please note that if you submit through our email and fax, you do not need to fill out the online referral form.

 

*Surgical wounds created in the last 90 days must have an order from the surgeon approving West Coast Wound to evaluate and treat due to a 90-day global period.

Choose the Right West Coast Wound Center Location to Refer Your Patient

Fresno

  • 3636 N First St Suite 150, Fresno, CA 93726

  • Phone: (559) 825-1980
  • Fax: (559) 825-1981

  • info@westcoastwoundcenter.com

Northridge

  • 8349 Reseda Blvd., Suite F Northridge, CA 91324

  • Phone: (818) 928-0004
  • Fax: (818) 928-0005

  • northridge@westcoastwoundcenter.com

Inglewood

  • 323 N Prairie Ave, Suite 320, Los Angeles, 90301

  • Phone: (424) 480-1800

  • Fax: (424) 480-1880

  • inglewood@westcoastwoundcenter.com

Austin

  • 4422 Pack Saddle Pass Suite #103, Austin, TX 78745

  • Phone: (512) 649-9712

  • Fax: (512) 649-9752

  • austin@westcoastwoundcenter.com

Visalia

  • 428 S. Garden St., Visalia, CA 93277

  • Phone: (559) 931-2524
  • Fax: (559) 931-2526

  • visalia@westcoastwoundcenter.com

Refer a Patient

Wound Care at Home

  • Phone: (818) 856-9535

  • Fax: (818) 979-0593

  • info@westcoastwound.com

West Coast Wound and Skin Care offers comprehensive wound care services for patients in various settings, including their homes, assisted living facilities, and board and care communities.

Submit a Patient/Self Referral
Service Areas

We accept Medicare, PPO, and HMO insurance plans.