How to Make a Referral?

Please call our our TMS coordinator, Camice, at 719-359-8812. 

Alternatively, you may wish to ask your patient to fill in the contact form at the bottom of the page, to gain access to our medical history questionnaire. 

This questionnaire gives us the basic information insurance companies require for submittal.

Without such detailed information, most insurance companies will not agree to pay for TMS.

Is a referral letter needed? What else?

If the patient can get a printout from their pharmacy, this may speed up your process. They should request that it extends back the maximum number of years possible.

We will need a referral letter from you. Please include:

  1. The patient’s diagnosis
  2. The reason for the referral (such as mediation failure or intolerance to medication side effects)
  3. Patient history with a much detail as you can including:
    • Each medication  given to the patient
    • The exact doses given
    • Start and stop dates
    • The impact of the medicine
    • The patient’s side effects, if any