Thank you for considering a patient referral.
We admit patients 24 hours a day, 7days a week. This referral will be compliant with HIPAA regulations and will be processed confidentially. To ensure a smooth and efficient admittance process, please provide the following information in the secure form below or call us at 800-245-4746.
- Livengrin will reach out to you before we contact the referred patient.
- Livengrin will contact the patient and use your name as the referring party.
- If we cannot reach you, we will contact the patient. By summiting this form, you are providing Livengrin with your approval to contact the patient.