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Referral Process

To refer a patient, simply send a face sheet or demographics sheet of the patient to:

 

Email: info@proactivehealth.tech

or

Fax: 888-823-5887

Needed information on face/demographics sheet: 

  • Name

  • DOB 

  • SSN 

  • Address

  • Insurance

  • Phone Number

  • Diagnoses

Or, send us their name and number and we can reach out to them

Enter patient info here:

Thank you! We'll reach out.

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