Please provide the patient’s insurance information and basic details such as name, date of birth, address, and phone number.

This verifies coverage, eligibility, and accurate patient information for timely processing.

Please include documentation of the physician visit where the patient was evaluated and home health was discussed.

Please send signed physician orders indicating the home health services requested.

Allows our clinical team to safely begin care as directed by the patient’s physician.

Please include the most recent history and physical exam from the physician.

Please provide a current list of all medications the patient is taking.

This ensures medications are reviewed for safety, accuracy, and proper coordination during care.

Please include recent clinical notes related to the patient’s condition or hospitalization.

Please fax all referral documents to this number for secure review and so that we can respond quickly.