Making a Referral

Thank you for your consideration in referring your patients to NDBC. Referring a patient to NDBC is very easy. Simply follow the steps outlinned below. Should you have questions about referring your patients to NDBC, or if we can be of help in any way, please don't hesitate to call us with all your questions at 952-345-3000.



Please fill out the top portion of the order form with the patient's insurance and contact information, have the physician sign and date, and send it our way! Once the order is received, we take care of all the insurance verification in our billing department, and also call the patient to schedule their appointment. No fuss for you!

STEP 2: 
Fax the required patient referral form to the appropriate NDBC clinic:

To access our referral forms, click here.

Edina - (952) 345-6789 
Blaine - (763) 786-6901
Woodbury - (651) 221-0303
Burnsville - (952) 808-9001 

STEP 3: 
Give referral form to patient so they can use the map to find NDBC, or print one from our website. 

Information Requested for Referred Patients - *But not required for referral* 

1. Referral form, items completed: (required) 
    a. Patient demographic & insurance information
    b. Type of service requested
    c. Diagnosis or reason for referral
    d. Referring physician name, clinic, & signature

2. Relevant history and physical information if available
3. Most recent therapy notes if available
4. Most recent progress notes if available 
5. Medication list