In order to expedite the referral process we have compiled the following list of suggested items needed to make a clinical determination. You will be notified once a clinical approval has been obtained. When clinical approval has been obtained we begin the process of financial verification.
All Admissions Require:
- A negative chest x-ray or PPD, done no more than 30 days prior to admission.
- A statement from the referring physician stating that the patient is free from communicable disease.
Required Documents
- Copy of current face sheets
- Copy of current medication lists
- History and Physical
- Current Labs
- Physician progress notes (3 days)
- Nursing Notes (3 days)
- Current staffing report
- Therapy progress notes
- Financial/Insurance information
- Copy of POA or guardianship (if applicable-activated and non-activated POA's)
Required Children's Documents
- Copy of childhood immunizations (must be received prior to admissions)
- Copy of IEP'S (Individual Educational Programs and any pertinent school records)
- Copy of birth certificate (may be forwarded upon admission)
Additional Required Documents for Children Over 14
- Copy of Social Security Card
- Letter from custodial parent stating child has permission to work at Lakeview (work permit) for Vocational training program.
To Send Records
All records may be faxed directly to the admissions office
at
(262) 995-7433 or mailed directly to Lakeview Specialty Hospital & Rehab Center , 1701 Sharp Road, Waterford, WI 53185.
If you have further questions please email our admissions office or phone 1-800-611-2063 or (262) 534-7297.
