About Burke Inpatient Programs Physicians & Leadership Become A Patient Patient Information Life After Burke Blog

Become A Patient

Pioneering Rehabilitation

How to be Referred to Burke

As the vast majority of Burke patients are referred and transferred from acute care hospitals, we have included pertinent information for medical professionals in this section.

If you are a nurse case manager, social worker or discharge planner and would like to refer a patient to the Burke Rehabilitation Hospital, please include the following information with your referral:

  • Hospital Face Sheet (with patient's name, address and phone number)
  • History and Physical
  • Most recent lab work (CBC, Chemistry panel, etc.)
  • List of current medications (include pain and anti-coagulation medications)
  • PT/OT/Speech Therapy (initial evaluation and most recent notes)
  • Weight bearing status
  • Height/Weight
  • Known allergies
  • Previous 3 days of chart notes
  • EKG (when available)
  • Imaging (CAT scan & MRI reports when available)
  • Notes from any consulting physicians
  • Patient’s diagnosis
  • Potential date of transfer
  • Patient’s date of injury or onset /exacerbation of illness
  • Patient’s current functional level
  • Your contact information
  • Insurance provider information.

Where to Send the Referral

You may send your referral to the Burke Screening Department by telephone, facsimile, or email. 

Telephone: (914) 597-2519 or (888)-99-Burke (toll free)
Fax: (914) 597-2888
Email: screening@burke.org


Home Referrals

From time to time, patients are admitted to Burke from home.

If you are a patient or family member who would like to refer a patient to Burke from home, please download the Home Referral Form and have your or the patient's physician complete it. 

We ask that the physician completes a full physical exam within two weeks of referring the patient to Burke to insure that the patient is medically stable and able to participate in an intensive acute rehabilitation program.

We also ask that the Home Referral Insurance Form be completed with the patient's information.

Where to Send the Referral

You may send the completed referral form, insurance form and any other pertinent information to Burke's Screening Department by telephone, facsimile or email. 

Telephone: (914) 597-2519 or (888)-99-Burke (toll free)
Fax: (914) 597-2888
Email: screening@burke.org

For additional information about from home referrals, please contact the Screening Department at (914) 597-2519 and one of our dedicated registered nurses will assist you with the process.