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R3 Healing Patient Referral Form

At R3 Healing, we are dedicated to providing top-notch care for patients in need of specialized wound care and Hyperbaric Oxygen Therapy (HBOT). Our referral form allows healthcare providers to quickly and easily refer patients to our team for expert treatment. Simply complete the form below with the necessary patient and referrer information, and we will handle the rest to ensure your patients receive the care they deserve.

Please use the following form to refer a patient.

R3 Healing Patient Referral Form | Hyperbaric Oxygen Therapy & Wound Care Referrals

Patient Details

Parent / Guardian Details


Other Details


Please include requested documents below. We look forward to speaking with you soon!
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By submitting this form, you agree to be contacted by phone, email or text and that any associated call may be recorded for quality and training purposes. This form should not be used to transmit private health information, and we disclaim all warranties with respect to the privacy and confidentiality of any information submitted through this form.

Comprehensive Care Across the State of Texas

At R3 Healing, we are committed to delivering specialized wound care and Hyperbaric Oxygen Therapy services across Texas. From rural communities to urban centers, our dedicated team is here to ensure patients receive the highest level of care, no matter where they are located. We’re here to help with expert treatment, support, and a focus on your health and recovery, statewide.

Comprehensive Care Across the State of Texas

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