For Providers

Now accepting referrals!

We Partner with Michigan's Leading Health Providers to Deliver Seamless, Expert At-Home Wound Care

At Stay Home Wound Care, Novi's premiere mobile wound care service, we provide exceptional care to your patients by first understanding the importance of collaboration and communication. We go above and beyond to ensure a seamless experience for both you and your patients. You can now refer a patient through our online form below, or by downloading the referral form.

Download A Referral Form

Start An Online Referral

Easy Online Referral Form

Referring Agency

Referring Agency Fax #

Patient Information

First name

Last name

Patient Email

Phone

Patient Gender

Date of Birth

Month

Day

Year

Patient Location

Home

Facility

If facility, what's the facility's name?

Primary Care Physician Name

Primary Care Physician Phone

POA/Caregiver Involved?

Yes

If yes, name and contact

Emergency Contact

Primary Insurance:

Medication List

Wound Details

Wound Location

Approximate Size

Onset date of wound

Wound Diagnosis

Previous Treatments

Photos of wound, if possible

Preferred Pharmacy Name, Location and Phone

Additional Notes

Home Health Agency (if different from referral source)

Home Health Agency

Home Health Case Manager

Case Manager Name

Case Manager Phone

Case Manager Email

Home Health Treating RN

Treating RN Name

Treating RN Phone

Treating RN Email

Please be sure to also include the following:

Facesheet with insurance information

Most recent H&P

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

Why Partner with Us?

Seamless Coordination

Stay Home Wound Care proudly serves patients in Novi, MI with expert mobile wound care—bringing advanced treatment directly to their homes. We work closely with referring physicians, specialists, and healthcare teams, including home health agencies, to ensure seamless continuity of care and optimal outcomes.

Dedicated Staff

Every Stay Home Wound Care patient is assigned a dedicated care coordinator to manage scheduling, provide timely updates, and streamline communication—making the mobile wound care process effortless for your practice.

On Time Communications

We pride ourselves in transparent communication with providers, so you’re always informed and confident your patients are receiving the highest quality mobile wound care without ever leaving home.