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Easyreferrals E-Signature

Easyreferrals.com E-Signature. Search for the Provider that you wish to make a referral to. *Reminder* The least amount of search criteria entered the more results displayed. Locate the provider for your referral destination and click “Make a Referral”.

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Easyreferrals E-Signature

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  1. Easyreferrals.com E-Signature

  2. Search for the Provider that you wish to make a referral to. *Reminder* The least amount of search criteria entered the more results displayed.

  3. Locate the provider for your referral destination and click “Make a Referral”

  4. If your referral requires an Electronic Physician Signature click here.

  5. Make a Referral to any Provider

  6. Not finding your provider? Click Here

  7. * Fields are RequiredFields Place a check here to add Practice/Provider to your Favorites which will allow you to continue making referrals to this Practice/Provider until the MRS Verification process is complete. Submit & Continue with making referral. Cancel your Practice/Provider Add

  8. Practices/Providers that have a similar name or fax number are displayed here. Send Referral to the selected provider. Save Provider and send Referral. Cancel the process.

  9. Input the required fields into the referral order form below….. * Fields are RequiredFields

  10. Fax Provider Referral Form Send Referral via E-Fax

  11. Support Web Site: http://www.easyreferrals.net/support -------------------------------------------------------------------------------------------------------------------- • Technical Support Contact Information • John Pinto • jpinto@medicalreferralsource.com • 520-468-7688 Option #1

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