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

COVID-19 Update

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