Physician Referral
You can view and print the RCRC Physican Referral Form by clicking on the link below.
Click here for PDF Application
*The form 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 form will open in a new window. When you are finished, close the form window and you will return to this page.
Fax the completed application to: RCRC Physician Referrals, 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 Physicians Referrals
5200 NE 2nd Avenue
Miami, FL 33137
If you have any questions, call us at (305) 532-7246.
