Partners & referrals
Refer a patient in a few minutes
We bring wound care and medical visits to your patients and residents, and keep your team informed.
Start an online referralDownload referral form (PDF)Call (239) 688-6686
Who we partner with
- Home health agencies
- Skilled nursing & assisted living
- Hospice & palliative care
Why partner with Revitalize
- Reduce hospital admissions
- Improve outcomes
- Reduce staff burden
- Control costs
Our care coordination includes home health and facility coordination, provider communication, patient education, preventive planning, and compliance-focused documentation. Care coordination & support.
What to have ready
The referral asks for
Patient
Name, date of birth, phone, address, and insurance and policy number — or self-pay.
Clinical
Reason for referral, primary diagnosis, and whether the patient has received treatment in the past.
Contacts
Referring physician’s name and phone, plus a caregiver’s name and phone if applicable.
Prefer paper?
Download the Revitalize referral form (PDF) and complete it manually. Please call (239) 688-6686 to confirm the secure way to send it. Our fax line is (239) 688-6671.
Questions about partnering?
Call (239) 688-6686 or email info@revitalizehc.com — please don’t include patient health information in email.