For referrals 

  • Fill out and SUBMIT on-line form below  OR
  • Download form by clicking HERE and fax to 828.604.9018 (or scan and email to ridgelinetc@gmail.com

Questions on referrals please call 828.347.0522 OR Email us at ridgelinetc.com

 

REFERRAL DETAIL
Name
Name
Address
Address
Birthdate
Birthdate
Sex
Patient aware of referral ?

Please click HERE to download referral PDF file to fax to RTC