Get the free Referral Request for Rehabilitation Services
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If you live in Illinois and have a disability, the Division of Rehabilitation Services ... To apply for services, begin by completing the form below. ... Referral Source.
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How to fill out referral request for rehabilitation
How to fill out referral request for rehabilitation
01
To fill out a referral request for rehabilitation, follow these steps:
02
Obtain the referral form from the rehabilitation center or download it from their website.
03
Fill out the patient's personal information, including their full name, date of birth, and contact details.
04
Provide relevant medical information, such as the patient's diagnosis, current medications, and any existing medical conditions.
05
Specify the type of rehabilitation service required, such as physical therapy, occupational therapy, or speech therapy.
06
Include any additional information or special requests that the rehabilitation center should be aware of.
07
Sign and date the referral request form.
08
Submit the completed form to the rehabilitation center either by mail, fax, or in person.
09
Follow up with the rehabilitation center to ensure they have received and reviewed the referral request.
Who needs referral request for rehabilitation?
01
A referral request for rehabilitation is needed by individuals who require specialized rehabilitation services to aid in their recovery or manage their medical condition.
02
This includes individuals who have undergone surgery, experienced a traumatic injury, or are living with a chronic illness or disability.
03
Referral requests for rehabilitation are typically made by healthcare professionals, such as doctors, therapists, or nurses, who are involved in the patient's care.
04
Family members or caregivers can also initiate a referral request on behalf of the individual in need of rehabilitation.
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