Start the Referral Process
Care Therapy Group makes it simple for families, providers, care coordinators, and referral partners to begin the referral process for therapy and nutrition services.
Download Referral Forms
- 01
Choose Your State
Select your state to download the correct form. (Telehealth is available throughout New Jersey and Virginia. For New York, primarily in person.)
- 02
Complete the Details
Fill out the required information as completely as possible.
- 03
Send the Referral
Fax the completed form to our team for review and follow-up. Or contact our Regional Site Coordinator Ben Lebi
Cell: 212-810-7465
WhatsApp: +1 365-324-6877
Email: benl@selectmulticare.com
Website: www.selectmilticare.com
To begin a referral, download the correct form for your state, complete the required information, and send it to Care Therapy Group for review.
Please choose the referral form that matches the individual’s state or service area. Once the form is completed, fax it to Care Therapy Group so our team can review the information and follow up as needed.
If you are not sure which form to use, or if you have questions before submitting a referral, please contact our team for assistance.
We’re Here to Help You Take the Next Step
NEED HELP WITH A REFERRAL?
If you are unsure which form to use or have questions before submitting a referral, Care Therapy Group can help guide you through the process.