Respiratory Wellness Corp
Referral Form
Quick & Easy Referrals for Prompt Respiratory and Sleep Diagnostics
At Respiratory Wellness Corp, we are committed to working hand-in-hand with physicians, specialists, and healthcare professionals to provide timely, professional respiratory and sleep care for your patients. Our streamlined referral process ensures fast access to testing, clear communication, and continuity of care from assessment through treatment.
Submit Referral Online
Use our secure digital form to send patient information and service requests directly to our clinical team.
We currently accept both faxed referral forms and secure online submissions.
How to Refer a Patient
Referrals are accepted from:
- Family Physicians
- Specialists (Respirologists, Cardiologists, etc.)
- Nurse Practitioners
- Allied Health Professionals
- Case Managers and Insurers
Download a Referral Form
Prefer to fax your referral? Download and complete our standardized form:
Information Required
To process the referral efficiently, please include:
- Patient demographics and contact information
- Relevant medical history and current medications
- Specific tests or services requested (e.g., Sleep Study, PFT, Oxygen Assessment)
- Referring physician name, contact, and billing number
- Any previous reports or test results, if available
Why Refer to Respiratory Wellness Corp?
We’re now welcoming:
- Accredited facility with advanced diagnostics
- Board-certified specialists and experienced therapists
- Virtual and in-person care available
- Dedicated to patient education and therapy support
- Professional, collaborative approach to healthcare partnerships
Need help with a referral or have a question?
OR CALL US AT:
Fast Turnaround. Continuous Communication.
Once received, our team will
We combine the strength of clinical expertise with the convenience of modern healthcare delivery:
- Contact the patient within 1–2 business days
- Schedule testing at their convenience (in-person or virtual options available)
- Provide results and consultation summaries promptly to the referring provider