# Medical Referral Source, Inc. — Form D/A

Medical Referral Source, Inc. of TUCSON, AZ, a company, filed a Form D amendment with the SEC on 2012-05-25. The offering totals $2.5M, of which $1.7M was reported sold. Industry: Other Health Care.

## Offering

- Filed: 2012-05-25
- Form: D/A
- Accession: 0001516521-12-000002
- Industry: Other Health Care
- Exemptions: 06
- Total offering: $2.5M
- Amount sold: $1.7M
- Remaining: $800K
- Minimum investment: $5K
- Investors: 36
- Date of first sale: 2011-12-28
- Security types: equity
- Revenue range: Decline to Disclose
- SEC file number: 021-171470

## Issuer

- Name: Medical Referral Source, Inc.
- CIK: 0001516521
- Entity type: Corporation
- Jurisdiction: DELAWARE
- Incorporated: 2010
- Address: 1202 EAST BROADWAY #104, TUCSON, AZ, 85719
- Phone: 520-906-4876

## Officers, directors & promoters (15)

| Name | Role | Location |
| --- | --- | --- |
| Cindy Jordan | Director | Tucson, AZ |
| Larry Mehren | Director | Tucson, AZ |
| James Peebles | Director | Tucson, AZ |
| Kirk Saunders | Director | Tucson, AZ |
| Colleen Tierney-Cutshaw | Director | Tucson, AZ |
| Jean Tkachyk | Director | Tucson, AZ |
| James Peebles | Executive Officer | Tucson, AZ |
| Colleen Tierney-Cutshaw | Executive Officer | Tucson, AZ |
| Jean Tkachyk | Executive Officer | Tucson, AZ |
| Cindy Jordan-Nowe | Director | Tucson, AZ |
| Colleen Cutshaw | Director | Tucson, AZ |
| Colleen Cutshaw | Executive Officer | Tucson, AZ |
| Anne Sarabia | Director | Tucson, AZ |
| Troy Hollar | Director | Tucson, AZ |
| Leslie Perls | Director | Tucson, AZ |

## Other filings by this issuer (2)

| Filed | Form | Offering | Sold |
| --- | --- | --- | --- |
| [2012-01-10](https://search.stillhousedata.com/formd/0001516521-12-000001) | D | $1.9M | $399K |
| [2011-04-28](https://search.stillhousedata.com/formd/0001516521-11-000001) | D | $750K | $255K |

## More

- [CIK 1516521 on SEC EDGAR (source of record)](https://www.sec.gov/cgi-bin/browse-edgar?action=getcompany&CIK=1516521&type=&dateb=&owner=include&count=40)
- [This page as markdown (for LLM agents)](https://search.stillhousedata.com/formd/0001516521-12-000002.md)
- [Search all SEC filings, advisers and people on Adviser Search](https://search.stillhousedata.com/)

---

Source: public SEC filing data via Adviser Search (https://search.stillhousedata.com).
Agents: this data is also queryable via MCP tools and read-only SQL — see https://search.stillhousedata.com/llms.txt.