Providers & care partners
Refer a patient
Fax referral form
Home health
Assisted living
Skilled nursing
Physicians
Referral line 405-449-4491
Fax (877) 583-0878
← Referral partners
For referring providers
Refer a patient
Refer a patient for lymphedema treatment with the form here, by phone or by fax. Our intake team contacts the patient, verifies insurance and schedules the evaluation, and we report findings back to you.
Please don’t include detailed medical records here. We’ll collect them securely when we contact your office.
What to include
Information to refer a patient for lymphedema treatment
This is all we need to start. We’ll request anything else directly from your office.
- Your name, practice or facility, and a callback number
- Patient name, date of birth and phone number
- Diagnosis or reason for referral
- Insurance, if you have it
- Preferred setting: clinic, home, assisted living or skilled nursing
- Physician order, if the patient’s insurance requires one
After you refer
What happens next
01
We confirm
We let your office know we received the referral.
02
We contact the patient
Our intake team calls the patient or family, verifies insurance and schedules the evaluation.
03
Evaluation and treatment
A certified lymphedema therapist evaluates the patient and starts a written care plan.
04
Report back to you
You receive the evaluation findings and progress updates.