Wave

Wave Referral Form

This form is for healthcare providers who would like to refer a patient to Wave. The information from this form is stored in our HIPAA-compliant platform with stringent security measures in place to protect your patient's data. Your patient will hear from the Wave team within 48 business hours.
Have you informed the patient that you will be making this referral?
Do you plan to continue care with the patient?
Would you like to receive updates from the Wave treatment team?