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Send Us a Referral

Quick, Easy, and Secure

Sending us a referral is quick, easy, and secure. We offer 5 easy options to choose from:

  • Online: Fill out our secure referral form as the bottom of this page. Then upload your patient's 1) Rx, 2) Progress Notes, and 3) Face Sheet by clicking the "Choose File" button at the bottom of this page. Our online referral form is HIPAA compliant.
  • Fax: Fax your patient's 1) Rx, 2) Progress Notes, and 3) Fax Sheet to 510-799-9930.   A separate form is not required, but if you prefer to fill out a form to send along with your fax, you can download our DME Request/Referral Form by clicking here
  • athenaHealth: If you are an enabled athenaHealth practice, you already have the ability to send us referrals through your athenaClinicals EHR. For instructions, you can download athenaHealth's Quick-Reference Guide or view the athenaHealth Demo Video.
  • eReferral: If you're interested in sending us electronic referrals through Parachute, GoScripts, Epic, Straticeor DMEhub, please email us at [email protected] and we'll get your office set up to refer your patients to us through one of these ePrescribing platforms.
  • Phone: Call us at 510-799-9920 Monday - Friday / 8:30 am - 5 pm.

Your referral is our highest priority. Once we receive your referral, one of our Intake Coordinators will get in touch with you as soon as possible. We appreciate your referrals!

this is an image referral form

Online Referral Form

100% Secure & HIPPA Compliant

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