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For Physicians, Discharge Planners & Case Managers

Submit a Referral

Streamlined referrals, reviewed daily.

Refer a patient for nursing, personal, or therapy care. Our team reviews every referral daily to ensure timely communication and a smooth transition to care.

Submit a Referral(954) 431-1681

A smooth referral process

  1. 1

    Complete the referral form with patient & physician details.

  2. 2

    Our team reviews referrals daily for timely outreach.

  3. 3

    We coordinate with the physician's orders & plan of care.

  4. 4

    Care begins with a smooth transition & ongoing clinical oversight.

Urgent referral? Call us at (954) 431-1681 and we'll prioritize your case.

Referral Form

Please complete the form to refer a patient to Supreme Home Health Care.

Use this form to refer a friend, family member, or patient for nursing, personal, or therapy care. Our intake team reviews every submission daily and will reach out promptly to coordinate next steps.

Prefer to call?

(954) 431-1681

Secure & confidential

Your referral is handled by our licensed clinical intake team.

Please do not include Medicare/Medicaid numbers or other national identifiers in this form. We will request any documentation needed during our follow-up call.

Patient Information
Physician & Referral Source
Care Requested
Type of care needed *

Protected by reCAPTCHA. Referrals are confidential and reviewed by our licensed clinical team.