Refer a Patient
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 centralscheduling@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 Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.
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 centralscheduling@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 DEXA Screening Form
Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@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
- 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 centralscheduling@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 centralscheduling@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 centralscheduling@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 How Long
Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@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 centralscheduling@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 centralscheduling@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 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 centralscheduling@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 Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.
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 centralscheduling@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
Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@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
- Completed Order Form
Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@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
- 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 centralscheduling@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 centralscheduling@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 centralscheduling@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 centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.