For Medical Partners

We value our partnerships with referring providers and are committed to delivering timely, coordinated, and high-quality care for your patients. Our team works closely with your office to ensure a seamless referral experience, clear communication, and the best possible outcomes at every stage of treatment.

From initial consultation through recovery, we prioritize collaboration and transparency. You can expect prompt updates, detailed clinical notes, and easy access to our team whenever questions arise.

medical provider on the phone while typing

Refer a Patient

At Great Basin Orthopaedics, we make referrals easy. Complete the form below with your patient’s information and clinical details, and our team will promptly review and coordinate next steps. If additional documentation is needed, we will follow up with your office directly.

Referring Office Contact Information

Referring Physician

Your Name

Phone Number

Fax Number (Optional)

If you would like a confirmation of your patient’s appointment, please provide your fax number.

Patient Information

Patient Name

Date of Birth

Patient Phone Number

Patient Alternative Phone Number

Patient Email Address

Patient Insurance

If the patient’s insurance plan requires a referral to a specialist, please submit a referral to the insurance company prior to completing this form.

Reason for Referral

Does this visit relate to a workers' compensation claim?

Yes

Patient Has Completed

Bone Scan

CT Scan

MRI

EMG

X-Rays

Cast/Splint Applied

Sports Community

We are proud to support athletes and active individuals throughout our community. From youth sports to collegiate and recreational programs, our team is dedicated to helping patients stay healthy, recover quickly, and perform at their best.

We work closely with coaches, trainers, and organizations to provide education, injury prevention resources, and expert orthopaedic care when it matters most. Complete the form to share your athlete’s injury or concerns, and our team will follow up promptly with next steps.