By Fax or Phone

How to make a referral

Call us or fax your referral. Our intake department will confirm the plan of care you request and gather information about the patient’s clinical status, demographics and source of payment. Authorization to implement the care plan will be confirmed – and you’re done!

When receiving a referral, we need the following information:

  • Patient information (name, address, phone number, date of birth, social security number, insurance information, emergency contact)
  • Name of primary care physician / referring physician
  • Diagnosis (current and history)
  • Current medications
  • Services requested
  • Treatment orders (i.e. wound care procedures, PT orders, etc.)
  • Requested start of care
  • Mental status
  • Language spoken
  • Mobility status
  • Availability of backup caregiver, if necessary (name, phone number, capability, etc.) and willingness of caregiver to participate in care.

For referrals call 1-800-946-6331 or fax your referrals to 1-203-380-3229

Family Care Visiting Nurses has 5 locations throughout the State of Connecticut serving Fairfield, New Haven, parts of Hartford and Middlesex Counties