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REFER A PATIENT BY FAX                                                                        203-288-8205


Refer a Patient for Home Care by Fax:


Download or request a copy of our Patient Referral Form (see below)

Fax form to our Intake Coordinator @ 203-288-8205

REFER A PATIENT BY PHONE                                                                  203-288-8200


Call Home Health Specialty Services, Inc. and speak to an Intake Coordinator. 

Please provide essential patient information, including:

- Name, Address and Phone Number
- Social Security number and Date of Birth
- Current insurance information, including Medicare
- Emergency contact information
- Ordering MD’s name
- Primary diagnosis and reason for referral
- Types of services required
- Recent medical history
- Current medications



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