Licensed physical and occupational therapists treat your patients in their own homes across Rockland County, NY. Download our fillable referral form, then fax it to 973-759-0557 or send it by secure email.
Our two-page referral form is fillable on screen. Type in the patient, diagnosis and services, sign it, and send it.
Our preferred, most secure option. Faxes reach our intake team directly.
973-759-0557Send the signed PDF from your secure or encrypted email.
intake@holsmanwellness.com →Direct line for physician and hospital offices. Call with questions, or text that a referral is on its way.
Call 862-250-6697 → Text 862-250-6697 →Print, sign and give it to your patient or their caregiver, and ask them to call us at 855-465-7626.
Open the form to print →Protecting your patient's privacy: please fax the form or send it by secure email. Don't send diagnoses or other patient details by regular text message or unencrypted email.
We take it from here and keep you in the loop.
Our team calls the patient or their caregiver to schedule the first home visit.
We check the patient's benefits at no charge before the first visit.
A licensed physical or occupational therapist evaluates the patient in their home.
You receive the plan of care for signature when the plan requires it, as Medicare does, and progress notes as treatment goes on.
Treatment in the patient's own home means practicing on their own stairs, bathroom and kitchen, with no trip to a clinic.
We accept Medicare Part B, auto accident / No-Fault, Workers' Compensation and commercial PPO plans, and we verify each patient's insurance before the first visit at no charge.
Medicare Part B in-home therapy has no homebound requirement. It is for patients who are not under a home health agency plan of care.
For patients at risk of falling, our No Fall Protocol® uses standardized tests, including the Berg Balance Scale, Timed Up and Go and the 4-Stage Balance Test, so you can see measured change in your patient's fall risk.
Progress notes go back to you, the referring provider.
Home Therapy PT is led by owner and clinical lead Dr. Richard Holsman, PT, DPT, NCS, a board-certified Neurologic Clinical Specialist.
We are a sister company of Holsman Physical Therapy.
Two pages, fillable on screen. Works in Adobe Acrobat, Preview, Chrome and Edge. Page 2 lists where to send it and the towns we serve.
Fax 973-759-0557
Download PDFWe treat patients in their homes in these communities. Not sure an address is covered? Call 855-465-7626 and we'll confirm.