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

  • Please indicate which clinic location is preferred, or select Home Health Therapy.
  • All information below MUST be provided by the physician so that an evaluation can be scheduled.

  • This field is for validation purposes and should be left unchanged.