Submit a Patient Referral Inquiry
Submission of this form represents an inquiry about referring an adolescent or adult patient to Shepherd Center. It is the first step in the online patient referral process, but not a formal referral. For both inpatient and outpatient referrals, Shepherd Center requires the following before the referral process is initiated:
- Medical records submitted by the patient’s current healthcare provider or case manager.
- Records should be faxed to the Shepherd Center Admissions Department at 404-603-4504.
Once documentation is received, an evaluation may be done to determine if the patient is medically appropriate for Shepherd Center.
Before submitting the form below, please review the patient programs information on the following web pages to make sure you are submitting an inquiry about the appropriate program.
- Spinal Cord Injury Program (inpatient and outpatient services)
- Acquired Brain Injury Program (inpatient and outpatient services)
- Outpatient Clinics
- Shepherd Spine and Pain Institute (outpatient only)
- Multiple Sclerosis Institute (outpatient only)
- Complex Concussion Clinic (outpatient only)
- SHARE Military Initiative (day program and outpatient services)
Please note that Shepherd Center inpatient rehabilitation programs do not admit inpatients from home. If the patient is currently at home, please inquire about our outpatient services when completing the form below.
Also, Shepherd Center does not have contracts with Medicaid programs administered by states other than Georgia. Thus, treatment for patients with out-of-state Medicaid is typically not covered at Shepherd Center.
Due to capacity, Shepherd Center’s day programs for patients with spinal cord injury or brain injury are not accepting external referrals at this time. This does not apply to other outpatient services.