Make a Referral

We appreciate your confidence in allowing Alltech Prosthetics to care for your patients. We promise to treat them with the same level of compassion and caring they’ve come to expect from you. We also promise to keep you informed of their progress and do everything thing we can to ensure continuity of care.

In order to take care of your patient we will need you to submit a Request for Evaluation form along with a copy of your patient’s demographic information. Once you’ve completed the form, please fax it along with demographic information to 817-484-9877. We will contact your patient directly to schedule an evaluation appointment once we have the required documents.

Notice to Medicare Providers CMS has made changes regarding the necessary documentation by physicians signing for/prescribing prosthetic devices. Please Click Here to read the new requirements and ensure your records are in compliance with the new CMS guidelines. If you have any questions please feel free to call us at 817-484-9699, Ext. 7.

Alternatively, you can give the completed documents to your patient and ask them to call us directly to schedule an appointment.

Toll Free: 888-897-3231

Burleson Office: 817-484-9699