Make a Referral to Nascentia Health Home Care Intake Referral – new Please select the type of service(s) you are requesting: * Home Health Aide (Home Health, Personal Care, or Homemaker Services) Skilled Care (Nursing, Physical, Occupational, or Speech Therapy) Questions and/or check on an existing referral For questions and/or to check on an existing referral you can: Call: (315) 477-4663 Encrypted email: Aide referrals (Home Health Aide, Personal Care Aide, or Homemaker Services) to lhcsareferrals@nascentiahealth.org Skilled Care referrals (Nursing, Physical, Occupational, or Speech Therapy) to referrals@nascentiahealth.org Patient Name * Contact Phone Number: * (include area code) Reason for Referral: * Upload referral information below. Here is what we typically look for: Demographic Sheet Current Medication List Treatment Orders History and Physical Recent Visit Note including PT and / or Notes, if applicable Immunization Records Drop a file here or click to upload Choose File Maximum file size: 104.86MB Unable to use our online resource? Referrals can also be completed by downloading the Referral Request Form (pdf), completing it in its entirety and either: Encrypted email: Aide referrals (Home Health Aide, Personal Care Aide, or Homemaker Services) to lhcsareferrals@nascentiahealth.org Skilled Care (Nursing, Physical, Occupational, or Speech Therapy) referrals to referrals@nascentiahealth.org Fax: 315-477-9584 If you are human, leave this field blank. Submit