How to Submit a Referral to Crossroad Wellness Seminole:
Download & Print: Click the button below to access and print our official Medical Clearance & Referral Form for health and wellness.
Complete the Form: Fill out the patient details, select the requested modalities, and note any clinical precautions or anatomical restrictions, which may include lymphatic massage or reflexology options.
Sign and Return: Have the licensed provider sign the form, then return it to us via email or fax: Email: crossroadwellnesslmt@gmail.com
Once received, our team at Crossroad Wellness will contact the patient directly to schedule their initial consultation and treatment block.
