Referring Physicians | Westside Head & Neck

The decision to refer a patient to Westside Head & Neck should be easy. We also want the referral process to be easy for you, your staff, and your patients. We offer a few options to submit referral forms:

To Refer a Patient

Print and fax: Print the Referral Form, fill out, and sign. Once you’re done, please fax the forms and required documentations to 310-204-4474.
Email: Download the Referral Form, fill out, and sign. Once you’re done, please email to info@westsidehn.com, along with required documentations.
Fill out the forms online: Fill out and sign the form online. You can complete the Referral Form below and once you’re done, click ‘submit’ and it will automatically send to our team.

Our front office is your one-stop team for scheduling appointments.
Westside Head & Neck respects the relationships you have with your patients and is committed to open communication and prompt follow-up after your patient is seen. We recognize that your patient looks to you as his or her primary provider — and we expect to entrust your patient back to your ongoing care after being seen at our office.

We are an in-network provider for millions of people. To refer a patient, you don’t need to know a staff member at our office or have a previous relationship with us.

Why Refer Your Patient to Westside Head & Neck?

Quality.Our physicians are consistently up to date on new diagnosis and treatment techniques and refining and improving existing ones.
Locations. We have locations conveniently located in Los Angeles. With one location in the heart of downtown Culver City, and a second location in Santa Monica, our patients can be seen by our doctors with ease and convenience.
Ease.Fax, email, or fill out online—we offer several ways to refer patients, all streamlined to save time for you and your colleagues.
Expertise. Our expertise is found in few other medical offices, including novel treatment options and in-office services often done in a more expensive and less convenient hospital setting.
Collaboration. Working together with medical professionals in the community allows us to collaborate with you to provide the highest quality care to our patients.

Summary Notes

Our front office staff will collect your patient’s medical records once he or she is seen and ensure that you receive them in a timely manner via mail, fax or email. Our physicians will forward a summary of diagnostic reports and treatments to you as soon as it becomes available.

Fill Out Referral Request Online

If you would like to fill out the referral form online, you can do so by completing and attaching the necessary documents below. Once you click ‘submit,’ it will automatically send to our team:

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here at https://openpaymentsdata.cms.gov. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.

*As of October 1st 2023, Dr. Shapiro will be an out of network provider. Dr. Shapiro’s services will be fee-for-service and are not contracted with any insurance company. Payments are to be paid in full at the time of each visit or prior to the date of surgery. The fee schedule is available upon request. As a courtesy to our patients and to maximize your reimbursement, the office will provide you with a claim form to be submitted to your insurance. For out of network care we do not verify insurance coverage and assume the insurance information you provide is accurate. Reimbursements will come directly to you from your insurance carrier based on your plan's out of network coverage and deductible. We do not bill secondary policies. Please note that all other fees (facility and anesthesia fees for surgery, and tests such as labs or x-rays) will still go through your insurance as per regular insurance in-network contract.

COVID-19 ANNOUNCEMENT

At Westside Head & Neck, it is our highest priority to protect the health of our patients, staff, and community. As an essential business dedicated to serving the community, we will remain open with modified hours. We have implemented all guidelines set by the CDC and Department of Health with regards to ensuring safety and additionally installed state-of-the-art viral filtration systems in all rooms. Click here to read more.