For Referring Providers

Coastal Cardiology’s physicians recognize that our patients benefit from quick and efficient interactions. All contact methods on this page are HIPAA secure.


Referrals, records and other professional documents may be securely faxed to 805-782-8859.

eClincalWorks PEER-TO-PEER

A HIPAA-secure communication network for physicians. Click here.


Referral Request Attachments

Referring Offices

To Our Referring Providers:
Please use the following forms (or your own prescription/order) to facilitate your referral.

Referral Forms:
Coastal Cardiology Referral Form
Coastal Cardiology Diagnostic Imaging Referral Form

* Any stat referrals must be communicated by phone from the referring physician to a Coastal Cardiology physician. We look forward to speaking with you!
* Send completed forms in using the options on this page.
* Make sure you attach insurance cards and needed records.
* Please be sure the ordered items have a medically necessary diagnosis attached.
* Without medical necessity being demonstrated your patient may receive a bill for the services you ordered.
* Please be sure to check your patient’s insurance and published guidelines for assistance.

Thank you for your kind referral!

The Physicians of Coastal Cardiology

For MDs only: 805-782-8844 x 1