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To Submit a Referral:

Step 1: Fax Accessible

• Demographics with Insurance
• Last Two Office Visit Notes
• Current Medication List
• Orders from Provider with DX and Disciplines Ordered
• All Relevant Progress Notes i.e., Hospital, ER, Clinic Visits within the last 30 days, including DC Summary

Fax all documentation to:

(785) 493-8002

Step 2: Call Accessible

 Call our Intake Department to Confirm Receipt of Fax

(785) 493-8111
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You can reach us at:

Click Icon to Download Fillable Referral Form as PDF 

Form Downloads

We’re Here to Help!

If you have any questions as to how Accessible can help your
loved one, client, or patient please reach out to our community team.

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Lynsey Webb

Community Liaison

lwebb@accessiblehc.com

(785) 714-0629

Matt Hessman 

Community Liaison

mhessman@accessiblehc.com

(785) 416-0018

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