Quick Referral | Harmony Senior Living Advisors

What we can do for you:

Save time spent on discharges
Connect additional resources for successful transitions
Minimize readmissions
Decreased length of stay
QUICK response
Available 24/7 for referrals
Constant follow up

What we can do for your patient:

On site, same day consultations
Personalized tours at available assisted living communities with a Harmony Advisor
Become one point of contact for family for all parties involved in providing care
Knowledge of ALF availability, personalities, and licensure
Constant follow up

Please complete the following client contact information so a Harmony representative can contact your patient. We’re so excited to be your trusted partners during this discharge to ensure that your client receives the highest level of service available.

Your Patient

Just a name and contact is all we need to get started.

Patient's Name(Required)

First Last

Patient Phone Number

Patient DOB(Required)

Patient's Address

Street Address Address Line 2 City State ZIP Code

Will a family member be helping the patient make decisions?

Yes

No

Family Member Name

First Last

Family Member Phone Number

How Can We Reach You?

We would love to chat with you. How can we get in touch if we need more information?

Name

First Last

Your Organization

Preferred Method of Contact

We will try our best to honor your preferred method of contact, but in urgent matters we may use all available methods to gain the best outcome for your patient.

Your Email Address

Your Phone

Any patient details we should know?

Please let us know any particulars about your patient or their family that can make this transition as easy as possible.

Patient Notes

File Upload

If you have a Face Sheet, H&P, Med List, or 1823 ready you can upload those documents here.

Drop files here or

Max. file size: 100 MB, Max. files: 5.