Make a Referral
to Outreach Physical, Occupational and Speech Therapy
Medical professionals wishing to refer a patient for care may complete and fax the referral form. Alternatively, you can also send your standard prescription or EMR-generated prescription. If you are a patient seeking care, please share the referral form with your healthcare provider for them to send it to us.
Note: If only faxing a prescription, please specify if want your patient to receive therapy in their home or in our office clinic.
