Physician reviewing patient referral documents at a desk

For Physicians & Discharge Planners

Refer a Patient

Fast, HIPAA-compliant referrals for Medicare-certified home health care across DuPage, Cook, Kane, Kendall & Will counties. We typically begin services within 24–48 hours of approval.

Medicare Certified & IDPH Licensed

(630) 968-7777

Fax: (630) 968-7770

Mon – Fri, 8:30am – 5pm

How do I initiate a home health referral with Wellspring Healthcare Services?

Physicians and clinical case managers can send patient orders and medical notes directly to our team via fax at (630) 968-7770. Care coordinators are available Monday through Friday from 8:30 AM to 5:00 PM CST to handle intakes.

How It Works

Simple, Fast Intake Process

Submit the Referral

Fax, call, or complete the form below. Include the patient's diagnosis, insurance information, and any relevant clinical notes.

We Review & Verify

Our intake team reviews eligibility, verifies insurance, and contacts the patient or family within one business day.

Care Begins

A skilled clinician is assigned and an initial assessment is scheduled — typically within 24–48 hours of approval.

Who We Serve

Eligible Diagnoses & Conditions

We accept referrals for a wide range of diagnoses. If you're unsure whether your patient qualifies, call us — our intake team is happy to help determine eligibility.

Post-surgical recovery (hip, knee, spine, cardiac)
Stroke and neurological rehabilitation
Chronic disease management (CHF, COPD, diabetes)
Wound care and complex dressing changes
IV therapy and infusion services
Fall risk and balance disorders
Medication management and reconciliation
Orthopedic and musculoskeletal conditions

Prefer to fax?

Send patient orders and clinical notes directly to our intake team.

Fax: (630) 968-7770

Online Referral Form

Referring Physician

Physician Name *

Practice / Hospital

Office Phone *

Office Fax

Patient Information

Patient Name *

Date of Birth *

Primary Diagnosis / Reason for Referral *

Insurance / Payer *

Additional Clinical Notes

HIPAA Notice: This form transmits protected health information (PHI) to Wellspring Healthcare Services Inc., a covered entity under HIPAA. Information is used solely for treatment coordination and intake processing. By submitting, you confirm you are authorized to disclose this patient's information for the purpose of arranging home health services.

I confirm I am authorized to submit this patient's protected health information and consent to its use by Wellspring Healthcare Services for intake and care coordination purposes. *

Transmitted securely · HIPAA compliant · Our intake team follows up within one business day.

Questions About a Referral?

Our intake coordinators are available Monday – Friday, 8:30am – 5pm. Call or fax us directly.

Call (630) 968-7777

Fax (630) 968-7770