Dear Patient and Family

Your physician has ordered/recommended continued services after you leave our inpatient care.

You have the right to select any provider to provide the care ordered/recommended by your physician. This is your choice. If you have insurance, they may designate a selected network of providers for you depending on the care needed. We have provided a list of agencies below to assist you in making your decision. Please indicate the agency you have selected on this form. Each agency includes their current Medicare Star rating as well as their self reported readmission rate and length of stay.