Admission Application

You can view and print the RCRC Patient Application by clicking on the Patient Application button below.  The Application is in PDF format.  If you do not have Adobe's PDF Reader, you can download it free by clicking the Adobe logo at the bottom of the page. The Patient Application will open in a new window.  When you are finished, close the Patient Application window and you will return to this page.

Click here for PDF Application

Fax the completed application to: RCRC Patient Admissions, Fax (305) 795-8488 (This is a secure fax number.  We are HIPAA compliant and your information is protected by Federal and State laws) or mail the application to:

The Rosomoff Comprehensive Rehabilitation Center

a Department of Douglas Gardens Hospital
Attention: RCPC Patient Admissions
5200 NE 2nd Avenue
Miami, FL 33137

If you have any questions, call us at (305) 532-7246.