TeleGreen Medical

Referral Form

Here at Telegreen Medical, we will assess your patients condition to determine if and what plant-based treatment is a suitable option for them.

When completing your referral, please include the following information:

  • Current primary diagnosis
  • Symptoms and other conditions
  • Relevant medical history – past treatments including medications
  • Current treatments and medications
  • Regular doctor details

If you’d like to refer one of your patients to us, please complete the form below.

We may follow up and request more information from you.

We appreciate your referral and look forward to supporting you and your patient.