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The following document is a Referral Form:

REFERRAL FORM


Dear Visiting Doctor:
 
For your convenience, please feel free to download the office referral slip when referring a patient to my practice. 
 
If you are a new referring doctor, let me take this time to say thank you for allowing us to treat your patient.
 
Kindly contact our office with any questions you may have.  Our direct telephone number is (209) 525-9339.
 
Best regards,
DR. MICHAEL P. SHAW
drshaw@drmps.com