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A Message to Our Community Regarding Coronavirus (COVID-19)

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Refer A Patient

HealthBridge is always here for patients…and their families

To discuss our services further or refer a patient for evaluation, please complete the form below or call (847) 392-9000. A representative will quickly return your call and if applicable at this time, arrange for a physical evaluation of the patient. If it’s determined that HealthBridge does not offer the required level of service, we can assist you in finding a suitable option.

*Note: This page is intended only for patient-related questions and referrals. If you are making general inquiries about anything unrelated to placing a patient in one of our facilities, please send an email to info@healthbridgecc.com.

    Your First Name *

    Your Last Name *

    Your Email Address AND / OR Phone Number *

    Patient's First Name

    Patient's Last Name

    Relationship with Patient?

    Type of Illness or Injury

    Type of Insurance

    How Did You Find Us? *

    Comments / Concerns