WACO:  254.776.5533
TEMPLE:  254.742.2771

How To Refer A Patient

Throughout the referral process, we make it easy for you and your patients so your patients can get the care they need. We strive to keep you informed and report patient outcomes back to you as necessary, so you can help celebrate their successes every step of the way. Please follow the steps below or call us for more information.

1. Refer your patient

A prosthetic referral can be written on a facility script pad or aCPO script pad and must contain the following information:


  • Patient Name
  • Date of Birth
  • Location of Amputation (right (rt), left (lt), bilateral (bi-lat)
  • Level of Amputation
  • Order to "Evaluate for Prosthesis"
  • Licensed Signature
  • Send signed referral to:

  • Fax to 254.776.5590 (WACO) or 254.773.5363 (TEMPLE)
  • Call us at 254.776.5533 (WACO) or 254.742.2771 (TEMPLE) if you have questions
  • Give to patient to bring to our office

2. Review & Sign Detailed Prescription:

After CPO has evaluated your patient for his/her device needs, we will send the following for you to review and approve:

  • Detailed prescription, which will include all L-codes and descriptions for prosthetic services needed by your patient
  • Patient evaluation and justification for prosthetic services
  • Make any suggestions/recommend changes
  • Send signed detailed prescription to:

  • Fax to 254.776.5590 (WACO) or 254.773.5363 (TEMPLE)
  • Call us at 254.776.5533 (WACO) or 254.742.2771 (TEMPLE) if you have questions
  • Give to patient to bring to our office

3. Communicate with Us:

At this point, all paperwork has been signed and completed for the prosthetic care needed by your patient. If at any time, you or your patient has concerns about the fit or function of her/her prosthesis, please contact us by phone.
We want this entire process to be as smooth and efficient as possible. If you have any questions, concerns, or suggestions on how we can better serve you, please let us know. We are firm believers in the adage that if you like how we treat you, please tell others, and if there are ways we can treat you better, please tell us.

Waco Office

7724 Central Park Dr
Waco, TX 76712

254.776.5533

Temple Office

1407 S 31st ST Suite H
Temple, TX 76504

254.742.2771