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Welcome to the KeyScripts Online Referral Center

KeyScripts has simplified the online referral process.  Select the services you want, answer the required questions and submit.

A KeyScripts representative will contact you promptly upon receipt of the referral.

Fields marked with a * are required

Referral Information

Help Text

Claim Information

Claimant Information

Employer Information

Physician Information

Additional Information

Order Notes and Special Instructions

Submission Information

Maximum Allowed Attachments: 5
Allowed File Types:  .doc, .docx, .xls, .xlsx, .pdf, .jpg, .jpeg, .tiff, .tif, .png