
Refer a Patient
Northbound Health
HEALTHCARE PROVIDERS

PATIENT REFERRAL FORM
ONLINE FORM
We welcome patient referrals for patients in the Indianapolis, Indiana service area.
Step 1: Fax an order and cover sheet to (317) 795-0949.
Step 2: Please specify which services you would like for your patient in the order you are prescribing.
Step 3: We will reach out to the patient for an introductory call.
Patient Referral Form Request
Northbound Health Therapy Services
PHYSICAL THERAPY
Physical Therapy – innovative and specialized equipment for exercise prescription coordinated with education to improve mobility and function. Northbound Health Physical Therapy Services
OCCUPATIONAL THERAPY
Occupational Therapy - expertise and advocacy for complex rehabilitation technology needs to increase independence with mobility related activities of daily living. Northbound Health Occupational Therapy Services