Provider referrals · Irvine, CA

Refer a patient. We’ll take it from here.

Thank you for trusting us with your patient. Send the referral online in a few minutes. Every referral is seen by one physician — Sunny Raleigh, DO — who reads the records before the first visit, so your patient never starts from scratch.

Fax (949) 326-7049Referrals & recordsSecure online formSent straight to our office60 minutesFirst visit with Dr. RaleighBoard-certified ×2Neuromusculoskeletal & Family Medicine

Two ways to refer

You decide how much we take on.

Tell us on the referral form which one you want. If you’re not sure, call and we’ll talk it through.

Option one

Full consultation

Dr. Raleigh evaluates your patient, builds the treatment plan and manages their ongoing care for the problem you referred.

  • 60-minute first visit, records reviewed beforehand
  • Testing ordered only when the case calls for it
  • One physician of record, every visit

Option two

Procedure only

We provide the specific service you order, then your patient returns to your care.

  • IV therapy, hyperbaric oxygen, osteopathic manipulation or an InBody scan
  • No follow-up visits scheduled unless you ask for them
  • Your patient is not added to our marketing lists

How it works

Three steps, start to finish.

01

Send the referral

Complete the referral form and fax it to (949) 326-7049 with any recent labs, imaging, notes and a medication list. Or call (949) 326-7060.

Complete the referral form online and send it securely. Fax recent labs, imaging, notes and a medication list to (949) 326-7049. Or call (949) 326-7060.

02

We review and schedule

Our team reviews the referral and contacts your patient to schedule. If we need more clinical information, we contact your office.

03

Dr. Raleigh sees your patient

For a full consultation, she reads the records before the visit and spends 60 minutes on the first appointment. Procedure-only patients receive the service you ordered.

Referral form

Fill it in. Fax it over.

Send it securely.

Type straight into the form, then print it or save it as a PDF and fax it to (949) 326-7049.

Complete the form and send it straight to our office. Prefer paper? Print it and fax it to (949) 326-7049.

Private by designNothing you type here is sent over the internet or stored. The form stays in your browser until you print it, so patient information never passes through this website.

Protected health informationThis form is sent over an encrypted connection directly to Radiant Sun Medical’s HIPAA-covered practice systems. Nothing you enter is stored on this website.

Provider referralRadiant Sun Medical · Sunny Raleigh, DO
19722 MacArthur Blvd #110, Irvine, CA 92612
Fax to(949) 326-7049Phone (949) 326-7060
Referral type
Referring provider
Patient
Reason for referral
Records included with this faxRecords you will fax separately
Timing
Referring provider signature
Date

Please fax this form with supporting records to (949) 326-7049. Do not send patient records by regular email. Questions: (949) 326-7060.

Records can’t be attached here. Please fax supporting labs, imaging and notes to (949) 326-7049. Do not send patient records by regular email. Questions: (949) 326-7060.

Referral received.

Thank you. Our team will review it and contact your patient to schedule. If we need more clinical information, we’ll call your office.

Please fax any supporting records to (949) 326-7049.


What your patient can expect

The details they’ll ask you about.

60 minFirst visit with Dr. Raleigh, $900. Follow-ups are 30 minutes, $450.
Medicare & AetnaBoth in network. We are considered out-of-network with most other plans.
Claims submittedAs a courtesy, we submit the claim to the patient’s insurer as an out-of-network provider.
Prices postedEvery price is published before booking on the treatments page.

The patient’s plan determines what, if anything, it will pay. Patients are responsible for any amount their insurance does not cover, including deductibles, coinsurance, and the difference between our fee and the plan’s allowed amount. Please ask them to check their out-of-network benefits before the visit. Patients may also book directly — no referral is required.

Fax referrals to (949) 326-7049Refer a patient securely onlineStart a referral
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