Refer a Patient
Submit a secure home health referral online. Please provide the information needed for our intake team to review eligibility and coordinate care.
Supporting documents may also be faxed securely
Fax: (818) 688-4966
Secure submission: This referral form is hosted and processed in a HITRUST-certified application environment that is HIPAA compliant. Information entered in the form is sent directly to Apricot Home Health and safeguarded within secure servers. No patient data is stored on this website.
If the secure form does not appear, open the secure referral form in a new window.
Other Secure Referral Options
Scan a QR code to start a referral by text message or secure email.
SMS Referral
Email Referral