Referral Process

Please fax the following information to our corporate office when referring a patient to Specialized Wound Management for wound care services:

Wound Care

  1. A copy of the facility's face sheet. If the patient is on hospice, please document that on the face sheet and provide the name of the hospice agency.
  2. A copy of the Physician's written/telephone order. The order should read: S.W.M. to consult and treat wound(s) as indicated.
  3. A verbal authorization from the patient's POA or a signed authorization on a a Specialized Wound Management form. You can obtain a S.W.M consent form by calling 888.811.4677.
ALL INFORMATION SHOULD BE FAXED TO:
636.536.0526 OR 800.605.8906
* The S.W.M. nurse practitioner is unable to see a patient until the above information has been received and the referral processed by our corporate office.

Foot Care

​Please fax the following information to our corporate office when referring a patient to MD Advanced (S.W.M.) for foot care services:
  1. A copy of the facility's face sheet with resident's demographics and insurance provider.
  2. A copy of the Physician's written/telephone order. The order should read: May have Podiatry services.
  3. A written or verbal MD Advanced consent form from the patient or the patient's POA.
ALL INFORMATION SHOULD BE FAXED TO:
636.536.0526 OR 800.605.8906
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