Referring provider completes our referral form.
Services for Referring Doctors
Transforming lives from within™
At Holistique, we offer a wide range of IV services beyond our standard IV Lounge menu. Physicians outside of Holistique are welcome to refer patients for custom IV therapies that address chronic conditions and extend beyond general wellness treatments.
To refer a patient for IV therapy not listed in our standard menu, complete the Referring IV Patients form. Fax the form, along with the patient’s allergies, medications, most recent chart note, and labs, to 1‑833‑371‑1483. We recommend following up with a phone call to confirm and review the order.
Referral Process
How it works, step by step
1 2 Fax the completed form, with a complete list of allergies, medications, most recent chart note, and any relevant labs, to 1‑833‑371‑1483.
3 Holistique provider reviews the form.
4 Once approved, the referred patient is contacted and scheduled for IV administration.
If you have any questions, please feel free to contact us.
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