C & M Vital Care

C & M Vital Care Referral Forms

Address

  • 5567 Highway 43
  • Satsuma, AL 36572

Step 1

Select the Appropriate
Treatment Referral Form

Select your referral form from the box below.
If you do not see the correct form, please call 251.675.3228.

If you’re having trouble displaying the form on a mobile device, please make sure pop-up blockers are disabled.

Step 2

Submit Your Referral via Fax

Please do not email referral forms

Fax: 251.679.5917

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