Universal Psychiatric Medical Center

Universal Psychiatric Medical Center
3250 Wilshire Boulevard, Suite 930
Los Angeles, CA. 90010
(213) 739-0019
Dear (Dr) _______(Esq.)
[] Your patient, __________, was seen today for a pain related psychological evaluation.
Our initial clinical impression seems to indicate that the patient is experiencing
_____________(diagnosis) symptoms and therefore may be appropriate for a traditional
psychological evaluation to determine the nature and extent of the apparent symptoms.
[] (Also,) Please refer your client, _____________, to individual psychotherapy to
provide additional support to her/his in order to better manage current symptoms of
depression and anxiety related to her/his work injuries.
[] We will continue to provide her with (biofeedback therapy doctors follow ups
medication management) until which time Mr./Ms. ______ is successfully transitioned
into another treatment program.
[] We are closing the patient’s case out immediately as patient is scheduled to be declared
P&S. We are recommending immediate Future Psychiatric in the form of psychotherapy
to maintain patients safety.
Please contact Dr. Thomas Curtis, MD, at the number provided below. Thanks in
Referral for psychotherapy:
Dr. Curtis’ office locations closest to your client:
110 W. Ocean Blvd #M
Long Beach, CA. 90802
(562) 901-0822
1127 Wilshire Blvd #710
Los Angeles, CA. 90017
(213) 482-9434
The office will need faxed a claim form, an application form, a referral letter from the
PTP, and a report recommending psychotherapy to (818) 908-5185.
If I can be of further assistance please feel free to contact the office at ( )
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