Refer a Patient

nurse on the phone while looking at a paper chart in front of a computer

Brookings Health System accepts patient referrals from other providers for the following list of services. Please click on each service for information on how to refer a patient. If you have any questions, please contact Central Scheduling at (605) 696-8888 or the contact number listed for each service. 

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature
  • Type of Diagnostics (Stress Test, Holter Monitor, Cardiac Event Monitor, EKG)

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Discharge Date
  • Insurance
  • Hometown
  • History and Physical
  • Pulmonary or Cardiac
  • Supporting Documentation
  • Primary Physician
  • Cardiologist
  • Surgeon
  • Referral Site Phone Number

Please fax the order to Cardiac Rehab at (605) 696-8828. Questions may be directed to Cardiac Rehab at (605) 696-8065.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Type of Scan
  • With or Without Contrast
  • Patient Weight
  • Insurance Authorization
  • Physician Signature
  • Completed CT Screening Form

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Nuclear Medicine at (605) 696-8059.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Recent Lab Results
  • Physician Signature and Printed Name
  • Completed Diabetic Educator Form

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

A signed order is not needed for e-consult/telemedicine services. However, our scheduling team will need the following pieces of information in order to book the appointment:

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

No referral is required for foot care. If you would like us to contact the patient to setup an initial appointment, please send the following:

  • Patient Name
  • Date of Birth
  • Patient Phone Number

Please fax the information to Central Scheduling at (605) 696-8889 or e-mail BHSCentralScheduling@brookingshealth.org. Patients may also directly setup their own appointment by calling Central Scheduling at (605) 696-8888.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Referring Provider Phone Number
  • Service Request (Home Health, Hospice or HEARTH)

Please fax the order to Home Services at (605) 696-8832. Questions may be directed to Home Health & Hospice Director at (605) 696-8090.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Referring Provider Phone Number
  • Service Requested (Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Bath Aide)

Please fax the order to Home Services at (605) 696-8832. Questions may be directed to Home Health & Hospice Director at (605) 696-8090.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Referring Provider Phone Number
  • Service Requested (Home Health, Hospice or HEARTH)

Please fax the order to Home Services at (605) 696-8832. Questions may be directed to Home Health & Hospice Director at (605) 696-8090.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature
  • Dosage and Length of Treatment

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient/Representative Phone Number
  • Diagnosis
  • Payer Source: Medicare, Medicaid or Private
  • Physician Order
  • List of Current Medications
  • Recent History and Physical

Please fax the order to the Social Worker at (605) 696-8709 or call (605) 696-8714.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature
  • Type of Scan
  • With or Without Contrast
  • Patient Weight
  • Completed MRI Screening Form

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature
  • Patient Weight
  • Type of Scan

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Nuclear Medicine at (605) 696-8059.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature and Printed Name
  • Recent Lab Results
  • Completed Dietitian Order Form

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature

Please fax the order to Rehab/Therapy Services at (605) 696-8820. Questions may be directed to Rehab/Therapy Services at (605) 696-8060.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature

Please fax the order to Wound Care at (605) 696-8814. Questions may be directed to Wound Care at (605) 696-8068.

Order Requirements

Patients may walk-in with a signed doctor order for lab work at any time. Walk-in patients should present their signed order to the Emergency Department receptionist.

Formal referrals require: 

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature
  • Lab Tests to be Performed

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Laboratory at (605) 696-8048.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature
  • Patient Weight
  • Type of Scan
  • Completed Order Form

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Nuclear Medicine at (605) 696-8059.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature

Please fax the order to Rehab/Therapy Services at (605) 696-8820. Questions may be directed to Rehab/Therapy Services at (605) 696-8060.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Test Type (PFT, Mask Fitting, Pulmonary Screening)
  • Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient/Representative Phone Number
  • Diagnosis
  • Payer Source: Medicare, Medicaid or Private
  • Physician Order
  • List of Current Medications
  • Recent History and Physical

Please fax the order to the Social Worker at (605) 696-8709 or call (605) 696-8714.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature
  • Supporting Documentation
  • Completed Sleep Study Form

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature

Please fax the order to Rehab/Therapy Services at (605) 696-8820. Questions may be directed to Rehab/Therapy Services at (605) 696-8060.

Order Requirements

  • Patient Name
  • Contact Information for Person Making the Referral

Swing Bed patient referrals can be made by calling the Case Management department at (605) 696-8016. You may also fax a patient referral to (605) 696-8803.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature
  • Type of Scan

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Insurance Authorization
  • Physician Signature
  • Completed Wound Center Referral Form

Please fax the order to the Wound Center at (605) 696-8814. Questions may be directed to Wound Center at (605) 696-8068.

Order Requirements

  • Patient Name
  • Date of Birth
  • Patient Phone Number
  • Diagnosis
  • Type of Scan
  • Insurance Authorization
  • Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to BHSCentralScheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.


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