Cumming & Alpharetta, GA. Accepting new patients, urgent 48-hour appointments.(470) 380-7007Fax 866-851-2493care@northatlantavertigo.com
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Refer a patient

For ENTs, neurologists, primary care physicians, surgeons, case managers and attorneys. Fax referrals to 866-851-2493.

Download referral pad (PDF)
  • 15+ yearsof outpatient clinic care
  • Vestibular & pain specialistDr. Manan Patel, PT, DPT, TPS
  • 60-minute visits1-on-1 with a physical therapist
  • Medicare, BCBS & Tricarein-network. $129 self-pay option

Referral fax

866-851-2493
  • Evaluation summary within 48 hoursFaxed back to your office with objective oculomotor, positional and BioSway balance findings
  • Urgent appointments within 48 hoursAt our Cumming or Alpharetta clinic
  • Traditional Medicare, BCBS / Anthem and Tricare in-networkSelf-pay, personal injury (Letters of Protection, Auto MedPay) and Workers' Comp accepted

How to refer a patient

Fax is fastest. Call us if a patient needs to be seen urgently.

  1. Send the referral

    Fax to 866-851-2493 with demographics, insurance, diagnosis or ICD-10 code if known, reason for referral and any relevant imaging or test results.

  2. We schedule the patient

    We contact your patient to book at the Cumming or Alpharetta clinic. Urgent appointments are available within 48 hours.

  3. You receive our findings

    Within 48 hours of the first visit, we fax an evaluation summary with objective oculomotor, positional and BioSway balance findings back to your office.

Coverage and documentation

  • Traditional Medicare, BCBS / Anthem and Tricare in-network
  • Self-pay accepted, with an itemized superbill on request
  • Workers' Compensation with work-status reporting
  • Auto MedPay and attorney liens (Letters of Protection), with objective vestibular, oculomotor and spine documentation

Treating clinician

Dr. Manan Patel, PT, DPT, TPS
Certified Vestibular Specialist and Therapeutic Pain Specialist
NPI 1942521489. Georgia PT license PT012222

Who refers to us

We work alongside the clinicians and organizations that see dizziness, concussion and pain first.

ENT, neurology, primary and urgent care

BPPV, vestibular hypofunction, vestibular migraine, PPPD and balance decline, with objective infrared goggle and balance findings in every report.

Vestibular referral guide

Chiropractors

When a patient's dizziness comes from the inner ear rather than the neck, such as BPPV or vestibular hypofunction, we treat it and keep you updated, so you can continue their spinal care.

How we treat BPPV

Coaches, athletic trainers and schools

Concussion rehabilitation for persisting dizziness, visual strain and neck symptoms, with graded exercise and return-to-learn and return-to-sport support alongside the athlete's physician.

Concussion recovery guide

Personal injury attorneys and case managers

Letters of Protection, Auto MedPay and Workers' Comp accepted, with objective vestibular, oculomotor, balance and neck documentation and urgent 48-hour appointments.

Auto accident and injury care

Printable referral form

Print this form, or download it as a PDF for your exam rooms, then complete it and fax it to 866-851-2493.

Fax 866-851-2493Phone (470) 380-7007
care@northatlantavertigo.com

In-network: Traditional Medicare, BCBS / Anthem, Tricare. Also accepted: self-pay, personal injury (Letter of Protection, Auto MedPay) and Workers' Comp. Urgent visits within 48 hours. Evaluation summary faxed to you within 48 hours of the first visit.

Patient

Patient name
Date of birth
Patient phone
Diagnosis / ICD-10
Reason for referral, history and precautions

Orders

Evaluate & treatVestibular rehabilitationPer surgeon's protocolPer PT plan of care

Vertigo, balance and concussion

BPPV (positional vertigo)Vestibular neuritisLabyrinthitisUnilateral hypofunctionVestibular migraineCervicogenic dizzinessPPPDConcussion / PCSMénière's diseaseBilateral hypofunctionMal de DébarquementBalance and fall risk

Neck and spine

Neck pain / headacheCervical radiculopathyWhiplash / auto injuryHerniated or bulging discLow back painSciatica / radiculopathyPersistent (chronic) painOther: __________

Spine surgery rehabilitation

Cervical (ACDF / ADR)Lumbar fusionDiscectomyLaminectomy
Surgery date
Surgeon

Payment

Traditional MedicareBCBS / AnthemTricareSelf-payPI / Letter of ProtectionAuto MedPayWorkers' CompOther: __________
Member or claim number
Date of injury
Attorney / adjuster and phone

Preferred clinic

CummingAlpharettaEither / first available

Referred by

Name
Practice or law firm
NPI (providers)
Phone
Fax
Signature
Date

Fax with the patient's insurance card and any notes or imaging. Treating clinician: Dr. Manan Patel, PT, DPT, TPS, Certified Vestibular Specialist and Therapeutic Pain Specialist · NPI 1942521489

Download PDF

Ready for the room to stop spinning?

Call now or request a time. Urgent appointments within 48 hours.

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