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DOWNLOAD A REFERRAL FORM HERE

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UPLOAD A REFERRAL FORM HERE

100% Secure and HIPAA Compliant

We will check the benefits, get the admission paperwork handled and get right back to you on the scheduling of your patient. In order to get the process started we need the following form or your offices Patient Demographics & Insurance Information.

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To get an admission completed and the patient on service, please send the following.

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REFERRAL CHECKLIST

  1. Referral’s Demographic Information 

  2. Doctor’s Order 

  3. Clinicals 

  4. Face Sheet 

  5. Medication List 

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DALLAS

12660 Coit Rd., Suite 200

Dallas, TX 75251

 

Phone: (214) 328-8600

Fax:      (888) 385-6074

GREENVILLE

5402 Wesley Street, Suite B

Greenville, TX 75402

 

Phone: (903) 453-8082

Fax:      (888) 385-6074

MONDAY -FRIDAY

8:30 AM - 5:00 PM

ACCREDITED HOME HEALTH CARE, HOSPICE & PRIMARY CARE

Altruist Home Health Care
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© 1996-2022 Altruist Home Health Care, Inc.    I    Website & Brand Management by The Link Up LLC.

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