Referring Patients to the Keays Medical Group

As one of the Pacific Northwest’s only fibromyalgia specialty clinics, Keays Medical Group offers a multidisciplinary, integrative approach to care. We accept referrals for patients with depression and/or fibromyalgia.

In person
To speak to someone in person about a referral, call 253.779.5858.

By mail or fax
To refer by mail or fax, print and send the Referral Request Form.

Please include the following documents with this referral form:

  • Demographic Sheet
  • 3 chart notes with dates of service pertaining to patients Fibromyalgia
  • Medication Flow Sheet
  • Labs and imaging done during work up of fibromyalgia

Preparing Your Patient for a Fibromyalgia Consultation

To help your patient get the most out of their appointment, we ask for your help to prepare them. Below you will find several steps needed to set-up our visit for success. Thank you in advance for your help.

For guidance on the appropriate work-up prior to your patient’s visit, use the Fibromyalgia Diagnostic Criteria.

Diagnostic Screening Tools
For confirmatory validation of your diagnosis of Fibromyalgia, use the Fibromyalgia Impact Questionnaire (Revised) or the New Clinical Fibromyalgia Criteria Survey.

New Patient Paperwork
We will assist your patient with our New Patient Paperwork & will be sure to follow-up with you with any questions.

Online Referral Form

Thank you for referring your patient to Keays Medical Group. This form is to be completed by the referring provider. For more information please call (253) 779-5858

Patient Information:

Referral From:

Patient Need(s)
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