Referrals from Physicians

Process for Referrals

  • For referrals, please contact the clinic nearest to you.
  • Please provide signed orders for an evaluation for treatment.
  • Our staff will verify Medicaid and/or private insurance benefits.
  • Client’s caregiver/parent will be reached by phone to schedule the initial visit.
  • After the initial visit for an evaluation, the evaluating therapist will recommend the frequency of services in a Plan of Care to be approved by the PCP.
  • The therapist and scheduler will assist the family with scheduling appointments.

Download, print, and fill out our Physician Referral Form.


Complete our online Physician Referral Form below.

You may also fax your own referral form to the office closest to you.

Download a copy of our Physician’s Newsletter.

Physician Referral Form

Southwest - 8021 Bissonnet
West - 9432 Katy Freeway
Pasadena - 3333 Bayshore
North - 5206 Airline Dr.
Home Health Therapy

Patients Name

Physical Therapy
Occupational Therapy
Speech Therapy
All information below MUST be provided by the physician so that an evaluation can be scheduled.