Please provide the necessary information below for your client referral who is to receive HealtheMed’s “Clinic@Home” digital support system.
(i.e. Home and Community Based Services)
This form is HIPAA Compliant. Call 952-562-1235 with any questions.
We will let you know the referral was received and then work to get the services approved and/or coordinate shipping and remote setup. When the device is shipped or notifications have been set up we will follow up with you again to let you know. Thank you for the referral!