SMPC Scheduling: 877-377-6227 Email: [email protected]Additional med recs can be emailed to address above or faxed to 800-940-9601.To print a copy for your records, fill out then hit File > Print, from the File Menu before you select 'Submit this Form'.Please complete this form and click 'submit by email' above. Our scheduling department will call the patient to set up appointment and then call you to let you know appointment has been set. Red asterisk indicates required information. Thank you for the referral.