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How to Refer a Patient to 180 Medical

Referring patients to 180 Medical is easy! For your convenience, we offer 3 simple options:

E-Script: Send Referrals Quickly Online

180 Medical created our new E-Script option to better serve the needs of healthcare professionals and staff. No more filling out and faxing paper order forms. No more waiting on hold to make sure your order request for a patient was received.

E-Script is reliable, convenient, and practical, offering you an immediate email confirmation on orders. Plus, it’s an environmentally-friendly option that reduces paper waste. Most importantly, it’s easy to refer your patients for all their urological and ostomy supply needs.

Start your account and begin easily and securely referring your patients.

Quick Referrals

In a hurry? With E-Script Quick Referrals, you don’t even need to login to E-Script to send us your patients’ catheter supply needs. Simply access E-Script and select “Quick Referral.”

In just a few clicks, you can securely submit your referrals and go on with your day!

Email or Fax Patient Referrals Securely

Finally, if you prefer fax or email, these options are available too.

First, click on the below links to download a referral order form for intermittent catheters and/or ostomy products.

Next, simply fax it to us at (888) 718-0633 OR email it to us at

We will follow up with you within one business day to confirm receipt.

It’s not required, but in addition to the RX form, you can also send over your patient’s prescription or DWO (doctor’s written order), doctor’s progress notes (PDF), insurance, and any other relevant information to make the process even more expedient.

Call Toll-Free (877) 688-2729

How to Refer a Patient