Refer a Patient

Refer by phone at 1-866-784-1992 or fill out the form below.

Lifeline is focused on ways to support your needs related to patient safety and well-being. This is why we have created different ways for you to refer your patients to the Lifeline service. A Lifeline Representative will respond to the contact person within 24 hours (during regular business hours – Monday to Friday 8 am to 8 pm ET).