Practice Overview Sheet Thank you for entrusting Northwest Orthopaedic Specialists with your patients. Please fill out the form below, and we will contact your patient directly to schedule an appointment within 24 hours. For urgent appointments or fractures, please call our office directly at 888-660-2663. If you are a patient interested in making an appointment, please click here. Referring Office Contact Information Referring Physician * Your Name * Phone Number * E-Mail Address * Fax Number (optional) Patient Information Patient Name * Patient Date of Birth * Patient Phone Number * Patient Alternative Phone Number (optional) Patient E-Mail Address * Patient Insurance Symptoms & Diagnosis * Was this injury/condition related to Workers' Compensation? Yes No Patient Has Completed Bone Scan CT Scan MRI EMG X-Rays Cast/Splint Applied Does the patient have a request for a certain Doctor - None -No PreferenceChristopher G. Anderson, M.D.Joshua D. Dawley, M.D.Donald E. Ellingsen, M.D.Paul C. Horn, M.D.Martin Janout, M.D.Jonathan P. Keeve, M.D.Tycho E. Kersten, M.D.Michael H. Kody, M.D.Henry H. Lin, M.D.Patrick S. Lynch, Jr., M.D.Michael D. McDonald, M.D.Mark C. Olson, M.D.Soren L. Olson, M.D.Brian J. Padrta, M.D.Timothy W. Powers, M.D.A. Kirk Reichard, M.D.Jay B. Reynolds, M.D.Anthony M. Sestero, M.D.Khalid Shirzad, M.D.John K. Shuster, M.D.Antonie G. Tohmeh, M.D.Russell S. VanderWilde, M.D.Matthew K. Wallace, M.D.William L. Weigel, M.D. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.