Refer a

Patient

Working closely with healthcare professionals to ensure a fast and easy referral process.

Refer main Image

Home Service Representative from Lifeline shaking hands with a client in their home.


Working closely with healthcare professionals to ensure a fast and easy referral process.


We provide home/hospital visits to educate patients about the advantages of Victoria Lifeline's medical alert systems, ensuring peace of mind and understanding of our services.



If you would like Victoria Lifeline to

contact your patient:


(with their permission)

You can either refer online by filling out the fields below or by calling our office directly
at (204) 956-6777 or toll-free at 1-888-722-5222.

Fill out the Victoria Lifeline Referral Form to fax to our office - Fax # (204) 261-7719 or toll-free 1-877-784-6865

Referrals are processed quickly and our Education Facilitator will let you know the outcome of the referral.

 

Enter Your Contact Information

Subscriber Information

Patient Approval ?
Contact Caregiver ?
Contact Patient
Type of Referral Requested
Receive Updates?