Professional Referral Portal

Refer a patient or client

Secure, confidential referral pathway for clinicians, investigators, and professional partners.

Your Information

Professional Type *

Your Name *

Organization/Practice

Your Email *

Your Phone

Patient/Client Information

Patient/Client Name *

Patient Email

Patient Phone

Property Location

Medical/Project Context

Medical Context or Health Concerns *

Additional Referral Notes

Existing test/inspection reports?

Urgency

Upload Documents (optional)

Inspection reports, lab results, medical records, or other relevant documentation.

Click to upload files

HIPAA & Confidentiality

All information submitted through this portal is handled in accordance with HIPAA requirements and MedViro's confidentiality policies. Patient information is shared only with the assigned remediation team.

How It Works

Submit patient/client information securely through this portal

MedViro team reviews medical context and project needs

We contact both you and the patient to coordinate next steps

Ongoing communication with referring professional as requested

Coordination Options

MedViro can coordinate with referring professionals throughout the project — from initial review through post-remediation verification.

Questions?

Contact our professional referral coordinator for assistance with this portal or to discuss a complex case.

[email protected]