# country: US
# kind: medical-referral

[[ORGANIZATION|Cascade Family Health Clinic]]
[[ADDRESS|4100 Meridian Street, Suite 210, Portland, OR 97201]]
Phone: [[PHONE|(503) 555-0192]] · Fax: [[PHONE|(503) 555-0193]]

Date: [[DATE|September 9, 2026]]

RE: Referral for [[PERSON_NAME|Grace Whitfield]]
DOB: [[DATE|11/02/1991]]
Patient ID: [[REFERENCE|CFHC-77321]]

Dear Dr. [[PERSON_NAME|Priya Nadarajah]],

I am referring my patient, [[PERSON_NAME|Grace Whitfield]], to your practice, [[ORGANIZATION|Bellwood Orthopedic Associates]], for further evaluation of chronic lower back pain. She has a working diagnosis of [[MEDICAL_TERM|lumbar disc herniation]] ([[MEDICAL_CODE|M51.26]]) with associated [[MEDICAL_TERM|sciatica]] ([[MEDICAL_CODE|M54.30]]). Conservative treatment including physical therapy has not resolved her symptoms over the past four months.

Ms. Whitfield's medical history is notable for [[MEDICAL_TERM|type 2 diabetes]], well controlled on metformin, and a prior [[MEDICAL_TERM|rotator cuff repair]] in 2021. She has no known drug allergies.

Contact information for the patient: [[PHONE|(971) 555-0147]], [[EMAIL|grace.whitfield91@mailhaven.example]], residing at [[ADDRESS|228 Larch Street, Apt 3B, Portland, OR 97214]].

Please note that Ms. Whitfield works as a paralegal and will need documentation for a possible short-term disability claim if surgery is recommended. Her employer's HR department has requested a copy of any work-restriction notes; please send those directly to the patient rather than to the employer.

Grace period for insurance pre-authorization is typically ten business days with her plan, so I would appreciate scheduling within the next two weeks if possible.

Thank you for seeing Ms. Whitfield. My direct line is [[PHONE|(503) 555-0199]] should you have any questions before her appointment on [[DATE|September 23, 2026]].

Sincerely,
Dr. [[PERSON_NAME|Owen Bramwell]], MD
[[ORGANIZATION|Cascade Family Health Clinic]]
NPI: 1780245916
