Refer a Patient

If you are a patient, family member or caregiver, please call our Intake Department at 603-332-1133 or 800-691-1133.  If you are a provider, please see below for additional information.

Provider Referral

Making a referral is easy.  Read below and click on the icons to review our process and download our pdf forms.

CMS has relaxed regulations around a face-to-face (F2F) visit within the 90 days preceding a home health visit. For those needing a F2F, we are now able to accomplish this with the use of technology such as video chat via FaceTime, Zoom, or other teleconference technologies that offer real-time, two-way communication.

To make a referral to Cornerstone VNA’s Home Care, Hospice Care, Palliative Care, or Life Care (private duty), please call our Intake Department at 603-332-1133. Here are the documents needed to establish home care, which may be sent via fax to 603-332-9223:

  • Face sheet/patient demographics that includes a physical address & phone, and insurance information
  • Last 2 office visit notes (patient must have been seen within prior 90 days)
  • Current medication list
  • Reason that patient is home bound

Home Care
Referral Process

Referral Form

Attention Physicians Assistants
and Nurse Practitioners

Making a patient referral to home health care just got easier.
Learn more about the process for:


Why Patients Choose Us

Cornerstone VNA has received many local and national accolades in recognition of positively impacting the lives of families through our compassionate, high-quality care.

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