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Orthopaedic Associates of Michigan fax number

(616) 459-8609

Foot & Ankle Department

Used for: Consult Request Fax Form / referral submission for a medical consult

Fax destination details

Department
Foot & Ankle Department
Purpose
Consult Request Fax Form / referral submission for a medical consult
Form
Consult Request Fax Form — Consult Request Fax Form
Address
1111 Leffingwell Ave NE, Grand Rapids, MI 49525
Voice phone
616-459-3900

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Fill patient information (name, DOB, address, insurance), diagnosis/ICD-10, requesting physician, contact person, and fax to 616-459-8609 for a referral/consult.

Official form instructions are published as a downloadable file on the organization's website.

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