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REHABILITATION SERVICES REFERRAL APPOINTMENT STATUS: 24 HOURS 48 HOURS ROUTINE WentworthDouglass Hospital (Dover) 789 Central Avenue Dover, NH 03820 (603) 7402101 (603) 7402185 (fax) Therapy: Physical
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How to fill out rehabilitation services referral

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How to fill out rehabilitation services referral

01
To fill out a rehabilitation services referral, follow these steps:
02
Gather necessary information: Before filling out the referral, make sure you have all the required information about the individual needing rehabilitation services. This may include their personal details, medical history, and any relevant documents or reports.
03
Contact the appropriate authority: Reach out to the relevant healthcare or social services organization that handles rehabilitation services referrals. This could be a local hospital, clinic, or rehabilitation center. Inquire about their specific referral process and any forms that need to be filled out.
04
Obtain the referral form: Once you have identified the appropriate authority, request the referral form from them. This form will typically ask for detailed information about the individual's condition, the type of rehabilitation services required, and any supporting documentation.
05
Fill out the referral form: Use the information you have gathered to complete the referral form accurately and thoroughly. Ensure that all sections are filled out correctly and legibly.
06
Attach supporting documents: Gather any necessary supporting documents, such as medical reports or assessment results, and include them with the referral form. These documents help provide a comprehensive picture of the individual’s needs.
07
Submit the referral: Once the referral form and supporting documents are complete, submit them to the appropriate authority as per their instructions. This may involve mailing the documents, dropping them off in-person, or submitting them online.
08
Follow up: After submitting the referral, it is advisable to follow up with the authority to confirm receipt and inquire about the next steps in the process. Stay in communication with the authority to stay informed about the progress of the referral.
09
Please note that the exact process and requirements for filling out a rehabilitation services referral may vary depending on the healthcare or social services organization. It is important to consult with the appropriate authority for specific instructions.

Who needs rehabilitation services referral?

01
Rehabilitation services referral is typically needed for individuals who require specialized care, therapies, or support to recover, regain functionality, or improve their overall well-being after an injury, illness, or surgery. This referral is often required for patients who have undergone significant medical interventions or have been diagnosed with conditions that require professional rehabilitation services.
02
The following individuals may need rehabilitation services referral:
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- Patients recovering from major surgeries, such as joint replacements or organ transplants.
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- Individuals with physical disabilities, such as spinal cord injuries, amputations, or mobility issues.
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- Individuals with neurological conditions, such as stroke, traumatic brain injury, or Parkinson's disease.
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- People with chronic illnesses, such as multiple sclerosis, COPD, or cystic fibrosis, who require ongoing rehabilitative care.
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- Individuals with developmental disabilities or cognitive impairments that impact their daily functioning and quality of life.
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It is important to consult with healthcare professionals or social services organizations to determine if a rehabilitation services referral is necessary for a specific individual.
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Rehabilitation services referral is a process where individuals are referred to specialized programs or services to help them recover from injury, illness, or disability.
Medical professionals, social workers, or case managers are typically required to file rehabilitation services referral.
Rehabilitation services referral can be filled out by providing the necessary patient information, diagnosis, treatment plan, and desired outcomes.
The purpose of rehabilitation services referral is to connect individuals with the appropriate resources and support to help them regain their independence and improve their quality of life.
Information such as patient demographics, medical history, current diagnosis, treatment goals, and any other relevant information must be reported on rehabilitation services referral.
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