Submit a Referral


Home » Submit a Referral

To ensure a smooth transition of care, we stress the need for communication and coordination with our referral sources. We have dedicated Intake Coordinators and Pharmacists assigned to each account. They will provide you with consistent updates and follow up information prior to and after each patient’s start of care. Any questions or comments should be directed to our office.

The following information is needed for verification of benefits:

  • Name, address, phone number, date of birth, social security number (if available), and weight.
  • If patient is a minor, please include parent or guardian information.
  • A copy of insurance card with plan number, group number phone number, and primary and
    secondary coverage.
  • Prescription cards (if available),
  • (some patients’ benefits may be less expensive through prescription cards)
  • Diagnosis: primary and secondary if applicable
  • Written prescription
  • Start of care

A simple patient referral process.

Make An Online Referral