Submit a Referral Request
Please complete the form below, and one of our team members will be in contact with you shortly. Please also fax insurance information and latest patient records (labs/progress notes) relevant to the referral to (888) 920-6462, after submitting the form.
Referral Quick Links
We strive to offer a well-coordinated experience for our referring providers. Upon receiving your referral, our team will immediately begin processing the referral, with minimal work on your end.
Address
1500 East Duarte Road
Duarte, CA 91010
Contact information
Phone: (800) 826-4673
Fax: (844) 264-4357
Email: physicianrelations@coh.org
Referral Forms
Address
1000 Five Point
Irvine, CA 92618
Contact information
Phone: (866) 403-3373
Referral Forms
Address
600 Celebrate Life Parkway
Newnan, GA 30265
Contact information
Phone: (770) 400-6568
Fax: (770) 400-6900
Email: referrals@coh.org
Contact information
Phone: (847) 746-9990
Fax: (847) 342-4089
Email: referrals@coh.org
Address
14200 West Celebrate Life Way
Goodyear, AZ 85338
Contact information
Phone: (623) 207-3241
Fax: (623) 932-8631
Email: referrals@coh.org
Address
44151 15th Street West
Lancaster, CA 93534
Contact information
Phone: (877) 828-3627
Fax: (844) 264-4357
Referral Forms
Address
301 West Huntington Drive, Suite 400
Arcadia, CA 91007
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
301 West Huntington Drive, Suite 120
Arcadia, CA 91007
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
400 North Pepper Avenue
Colton, CA 92324
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
320 West 6th Street
Corona, CA 92882
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Contact information
Phone: (847) 746-9990
Fax: (847) 342-4089
Email: referrals@coh.org
Address
3530 S. Val Vista Drive
Suite C204
Gilbert, AZ 85297
Contact information
Phone: (623) 207-3241
Fax: (623) 932-8631
Address
222 West Eulalia Street, Suite 100-B
Glendale, CA 91204
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
720 East Colorado Street
Glendale, CA 91205
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
412 West Carroll Avenue, Suite 200
Glendora, CA 91741
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
202 S. Greenleaf St., Suite E
Gurnee, IL 60031
Contact information
Phone: (847) 746-9990
Fax: (847) 342-4089
Address
1043 Elm Avenue, Suite 104
Long Beach, CA 90813
Contact information
Phone: (562) 590-0346
Referral Forms
Address
3747 Worsham Avenue, Suite 101
Long Beach, CA 90808
Contact information
Phone: (562) 430-5900
Referral Forms
Address
15031 Rinaldi Street, Suite 150
Mission Hills, CA 91345
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
15031 Rinaldi Street, Suite 100
Mission Hills, CA 91345
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
1601 Avocado Avenue
Newport Beach, CA 92660
Contact information
Phone: (949) 629-4769
Referral Forms
Address
2915 W. Rose Garden Lane
Phoenix, AZ 85027
Contact information
Phone: (623) 207-3241
Fax: (623) 932-8631
Contact information
Phone: (847) 746-9900
Fax: (847) 675-3930
Email: referrals@coh.org
Address
38660 Medical Center Drive
Suites A300 and A380
Palmdale, CA 93551
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
630 South Raymond Avenue, Suite 220
Pasadena, CA 91105
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
6939 Palm Court
Riverside, CA 92506
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
401 East Highland Avenue, Suite D
San Bernardino, CA 92404
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
16300 Sand Canyon Avenue, Suite 207
Irvine, CA 92618
Contact information
Phone: (949) 333-7580
Referral Forms
Address
23823 Valencia Boulevard, Suite 250
Santa Clarita, CA 91355
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
26357 McBean Parkway, Suite 150
Santa Clarita, CA 91355
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
2100 Main Street #300
Huntington Beach, CA 92648
Contact information
Phone: (714) 908-0666
Referral Forms
Address
5522 Sepulveda Boulevard
Sherman Oaks, CA 91411
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
1157 Swallow Lane
Simi Valley, CA 93065
Referral Forms
Address
5215 Torrance Boulevard
Torrance, CA 90503
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
209 Fair Oaks Avenue
South Pasadena, CA 91030
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
11209 North Tatum Blvd., Suite B200
Phoenix, AZ 85028
Contact information
Phone: (623) 207-3241
Fax: (623) 932-8631
Address
44274 George Cushman Court, Suite 100
Temecula, CA 92592
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
425 Haaland Drive, Suite 101
Thousand Oaks, CA 91361
Referral Forms
Address
1100 San Bernardino Road, Suite 1100
Upland, CA 91786
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
1250 South Sunset Avenue, Suite 303
West Covina, CA 91790
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
7301 Medical Center Drive, Suite 100
West Hills, CA 91307
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257
Referral Forms
Address
36450 Inland Valley Drive, Suite 101
Wildomar, CA 92595
Contact information
Phone: (855) 502-2107
Fax: (844) 264-4257