Referral Resources

A medical referral form titled 'Durable Medical Equipment Referral Form' from MED Essentials, with sections for referring information, patient information, physician information, and DME/medical equipment information, including fields for names, contact info, insurance details, and diagnosis codes, and the company's address and contact number at the bottom.

Downloadable Referral Form

Referral Form (Adobe PDF)

Medical documentation checklist titled 'Referral Submission Checklist' with a list of required documents including patient demographics, insurance copies, physician order, clinical notes, diagnosis codes, contact info, delivery address, and optional additional documents.

Downloadable Referral Checklist

Referral Checklist (Adobe PDF)

Med Essentials complies with the Health Insurance Portability and Accountability Act (HIPAA). Patient information is handled securely and only used for treatment, payment, and healthcare operations.