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Essen House Calls is now rebranded as Intention Health Care

Same team. Same care. New name.

Refer a patient

Use the form below to refer a patient to Intention Health Care. Our team will follow up promptly to coordinate care and ensure continuity.

All fields marked with * are required.

Service request
Your information (referrer)
Patient information

Patient details are encrypted at rest and only accessible to authorized clinical staff.

Patient address
Insurance
Does the patient have Medicare? *
Does the patient have Medicaid? *
Clinical context & attachments
Hospital or SNF discharge in the last 6 months? *

Up to 5,000 characters. Avoid sharing more clinical detail than necessary.

Attachments (optional)

Up to 5 files, 10 MB each. PDF, JPG, PNG, DOC, DOCX, or TXT.

Best way to follow up with you *
Consent & authorization

Encrypted in transit and at rest. HIPAA-compliant handling.