CONTACT US

jennifer4new

Referral Checklist:

  • Fax prescription to (573) 681-0445. Please include patient name, diagnosis, ICD-10 codes if available, frequency, and duration
  • Fax patient face sheet with insurance and contact information
  • Fax copies of insurance cards, if available
  • Fax copy of protocol if applicable

Printable Forms: 

Download here.

Contact Information:

1739 Elm Court Suite 205/206 Jefferson City, MO  65101
Tel: (573) 681-0447
Fax: (573) 681-0445
E-mail: cjobe@outboundrehab.com