Empire Wound Care

Advanced Healing Solutions

Patient Referral

Follow These 5 Easy Steps:

Our mission is to provide your patients with the care they need—quickly and efficiently. We understand your workload, so we've made our referral process simple and hassle-free.

1 Gather Requirements for Referral

Face sheet (required). If you have a photo or any other supporting documents, you may include them in your email. You may also use our referral form as a guide on what information we may need to make a thorough assessment for your patient. Feel free to input any special notes in your email as needed.

2 Send Your Referral

Email the completed referral form and attachments to info@empirewoundcare.com

info@empirewoundcare.com

3 Confirmation & Scheduling

We'll verify the patient's insurance and assign them to a clinician. Patients will be seen within 24–48 hours.

4 Clinician Update

After the visit, our clinician will call or message you with preliminary feedback.

5 Final Report

A detailed wound care report will be sent to you within 24 hours of the visit.

Patient Referral Form – Empire Wound Care


Have Questions? Need Assistance?

Our team is here to help!

FAST REFERRALS. SEAMLESS COMMUNICATION. BETTER PATIENT CARE.