Available 24 hours / 7 days
Physician OrdersStaff Login 734-425-0001
U.S. Medical Equipment

Refer a patient for equipment

Send a referral any time, day or night.

For case managers, discharge planners, hospitals, facilities, home health agencies, physician offices, and other healthcare professionals. U.S. Medical Equipment accepts referrals 24 hours a day, 7 days a week. Our intake team will review the referral, confirm receipt, verify the information provided, and coordinate next steps for equipment delivery.

For urgent referrals, call U.S. Medical Equipment directly at 734-425-0001 or toll-free 800-424-8244.

Referral form

Fields marked * are required.

Referring party

Referring party

Preferred contact method
Patient information

Patient information

Is this also the equipment delivery address?
Current patient location

Current patient location

Where is the patient currently located?
Is the patient being discharged?
Equipment needed

Equipment needed

Select all that apply. Please note: U.S. Medical Equipment does not provide orthopedic equipment, wrist splints, lumbar supports, CPAP/BiPAP, pediatric ventilators, or lift chairs.

Respiratory
Durable medical equipment
Mobility
Bathroom safety
Specialty
Clinical information

Clinical information

Insurance

Insurance

Is this related to:
Ordering physician / practitioner

Ordering physician / practitioner

Has the physician order already been obtained?
Document uploads

Document uploads

Attach any supporting documents: physician order, face sheet, insurance cards, clinical notes, discharge documentation, testing/results, or other supporting documentation. Accepted files: PDF, JPG, JPEG, PNG (up to 20 MB each). Multiple files allowed.

Delivery / timing

Delivery / timing

Priority
Additional information

Additional information

Confirmation

Confirmation

Our intake team will review the referral, confirm receipt, verify the information provided, and coordinate next steps for equipment delivery.

Call U.S. Medical