Referral From Physician

Thank you for working with Solace Pediatric Home Care. We look forward to providing the best possible service to you and your families. We are devoted to working with our referrers as true partners, so you get the attention, answers and action you need right away.

How to Refer Your Patient:
Option 1: Complete the on-line referral form and upload the required medical records (including ICD-10, allergies & medications, order for evaluation & visit note),

Option 2: Complete referring information for contact and upload your office referral form and required medical records (including ICD-10, allergies & medications, order for evaluation & visit note)

Option 3: Fax your referral form and required medical records (including ICD-10, allergies & medications, order for evaluation & visit note) to 855-937-5828.

Process for Referrals

  • Complete our Referral Form and attach required medical records by one of the options listed above or call our team at 303-432-8487
  • Once we receive the referral, we will respond to you within 48 business hours to confirm the patient qualifies for services
  • Private Insurance and/or Medicaid will be verified
  • Our staff will schedule an initial evaluation with the parent/caregiver
  • The evaluating therapist will recommend frequency of services and schedule visits
  • Therapy services will begin after the physician signs the plan of care and authorization is received from insurance company and/or Medicaid

If you are a physician office and would like to submit a referral and upload required medical records (including ICD-10, allergies & medications, order for evaluation & visit note), please click link below to be redirected to our secure and encrypted contact form.

Make a Referral