CGM Referrals

Refer A Patient

Questions? Give us a call at 1-800-455-5211

3 Easy Steps to refer your CGM Patients

  1. Complete the form below and submit
  2. Click on the PDF link
    • Print, sign and date it
  3. Fax back the form to 1-888-570-2590

Please call the Physician Relationship team at 1-800-455-5211 to get set up on the DMEscripts platform
Or
Send us an email to