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 Referrals
 
 Cardinal Hill Rehab Unit - Referrals
Thank you for your interest in making a referral to Cardinal Hill Rehab Unit at Samaritan Hospital.
An Admission Facilitator will review and assess the patient as necessary. The Admission Facilitator will also determine the best plan of care for the patient.
 
For more information or to make a referral to the Cardinal Hill Rehab Unit, please call (859) 367-7120 or (800) 843-1408.  To make a referral on line, please fill out and submit the form below.
 
For more information on the Cardinal Hill Rehab Unit at Samaritan, click here
         

 
 CHRH/Cardinal Hill Rehabilitation Unit Referral Form
Patient Identification
Full Name
Address
City
County
State
Zip Code
Phone Number
Email Address
Person Making Referral
Full Name
Address
City
State
Zip Code
Phone Number
Email Address*
* Please note that a valid email address is required if you wish to receive electronic confirmation of your referral.
Professional Status OR Relationship To Patient
Professional Status
Relationship To Patient
Referral Reason
Area you are requesting:
Best time for someone to contact you:
       



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