Empower Physical Therapy & Wellness

Physicians Referral

We make it easy for physicians in Chino Hills, Chino, and Pomona to refer a patient for evaluation and treatment. Here's how the process works, and what we need from you to get your patient in and moving again.

Printable Referral Pad

Fill it out, fax it, or hand it to your patient.

Physical Therapy Prescription Pad

Diagnosis, services, and treatment frequency in one printable page, plus our Chino Hills and Chino office fax numbers.

Download →
Request an Appointment

Have a patient to refer?

HoursMon/Wed/Thu 9am–6pm · Tue/Fri 8am–5pm
Walk-insCall ahead
Book your evaluation. We'll call to confirm your time.
Step 1 of 6
First things first. What's your name?
Best number to reach you?
And your email?
What questions do you have about your pain or injury?
Which location would you like to visit?
Look right? Send it.
✓
Request received.

We'll call within business hours to lock in your time.