Referral Form

By submitting this referral request, you authorize the Vestibular Disorders Association (VeDA) to share your contact information with the healthcare provider you have selected. Providers listed in the VeDA Provider Directory participate on an opt-in basis and are not employees, agents, or representatives of VeDA. Inclusion in the directory does not constitute a recommendation, endorsement, or guarantee by VeDA of any provider's qualifications, services, or quality of care. VeDA does not verify or independently evaluate the qualifications, credentials, licensure, or competence of providers listed in the directory and is not responsible for the quality of care they provide. VeDA also does not guarantee that a provider will respond to your request or do so within any particular timeframe. By using this referral service, you acknowledge that you are solely responsible for selecting and evaluating your healthcare provider. You agree to release, indemnify, and hold harmless the Vestibular Disorders Association, its directors, officers, employees, volunteers, and agents from any claims, damages, losses, liabilities, costs, or expenses arising out of or related to your use of this referral service or any care, treatment, advice, or services provided by a listed healthcare professional.