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SAM KARA ACUTE REHABILITATION REFERRAL FORM To make a referral call 8312401499 Fax 8882064623 Date: Total pages: From: Referred by: Referring Physician: Phone: Fax: PCP: Patients Information: Name:
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Begin by providing your personal information such as your name, date of birth, and contact details.
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Fill in the details about your medical condition or injury that requires rehabilitation.
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Sam Karas Acute Rehabilitation is a specialized program designed for individuals recovering from severe injuries, surgeries, or medical conditions that require intensive rehabilitation services.
Patients who are admitted to the program for acute rehabilitation services are required to file the Sam Karas Acute Rehabilitation documentation.
To fill out the Sam Karas Acute Rehabilitation documentation, follow the provided guidelines, include necessary patient information, treatment plans, and progress notes as required.
The purpose of Sam Karas Acute Rehabilitation is to facilitate recovery through targeted therapy and support, ensuring patients regain their physical and functional abilities.
Information that must be reported includes patient demographics, medical history, rehabilitation goals, treatment progress, and any adverse events or changes in condition.
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