Skip to main content

Workers Compensation Referrals

Acute referrals will be addressed within 24-48 hours. All other referrals will be addressed within 5-7 business days. Please send records in chronological order and include the following: Past treatment notes pertinent to the injury/condition being evaluated. This includes progress notes, radiology reports, operative reports. PT/OT progress notes, injection records, diagnostic testing, and pain management progress notes. A detailed functional job description is needed to effectively address restricted work abilities. Records can be faxed 515-221-6566 or email workcomp@dmos.com Questions can be directed to workcomp@dmos.com or 515-224-1414, options 5 OR 515-224-4213.
  • Patient Information

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Employer Information

  • Workers' Compensation Insurance Carrier Information

  • Workers Compensation Case Manager Information (if assigned)

  • Medical Records

    Please attach any medical records here.
  • Drop files here or
    Max. file size: 50 MB.
    • Sign and Submit

    • MM slash DD slash YYYY
    • This field is for validation purposes and should be left unchanged.
    Info

    West Des Moines

    6001 Westown Parkway
    West Des Moines, IA 50266

    Departments

    Physician & Sports Medicine Clinics

    Mon – Fri 8am – 5pm

    Interventional Physiatry & Spine Center

    Mon – Fri 8am – 5pm

    MRI

    Mon – Fri 6am – 7:30pm, Sat – Sun 8am – 4pm

    Urgent Injury Clinic 

    Mon – Th 10am – 6pm, Fri 10am – 5pm, Sat 8am – 12pm

    Physical & Hand Therapy

    Mon – Fri 7am – 7pm

    Ankeny

    350 NE 36th Street
    Ankeny, IA 50021

    Departments

    Physician & Sports Medicine Clinics

    Mon – Fri 8am – 5pm

    Interventional Physiatry

    Mon – Fri 8am – 5pm

    MRI

    Mon – Fri 6am – 7:30pm, Sat – Sun 8am – 4pm

    Urgent Injury Clinic

    Mon – Fri 7am – 3pm, Sat 8am – 12pm

    Physical & Hand Therapy

    Mon – Fri 7am – 7pm

    Des Moines

    1301 Penn Ave., Suite 213
    Des Moines, Iowa 50316

    Departments

    Physician & Sports Medicine Clinics

    Mon – Fri 8am – 4:30pm

    Physical & Hand Therapy

    Mon – Fri 7am – 7pm

    Masks are optional.
    Skip to content