Provider Learn More

Learn More, Refer A Patient, and get in contact with the Clinical Liaison.

FAX Patient Referral Form

Download FAX Referral Form

FAX To: (818) 450-0350

A pulmonary rehabilitation telehealth referral form with sections for patient info, medical information (checkboxes for lung conditions), provider info, and fax details for Breathe Better Rehab. Includes contact information at the bottom.