Refer A Patient

Refer a Patient

Complete a simple form and we’ll get right back to you. View our healthcare plans or contact us with questions.

Refer A Patient
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To discuss our services further or refer a patient for evaluation, please complete the form below or call 800.852.1256. A representative will quickly return your call and if applicable at this time, arrange for a physical evaluation of the patient. If it’s determined that CareMeridian does not offer the required level of service, we can assist you in finding a suitable option.

*Note: This page is intended only for patient-related questions and referrals. If you are making general inquiries about anything unrelated to placing a patient in one of our facilities, please send an email to

Your First Name *

Your Last Name *

Your Email Address AND / OR Phone Number *

Patient's First Name

Patient's Last Name

Relationship with Patient?

Type of Illness or Injury

Type of Insurance

View a full list of Health Plans we participate with as an “In Network” provider.

How Did You Find Us? *

Comments / Concerns