There are several ways you can request services:

  1. Contact your physician and they can refer our services.
  2. If you or a loved one is in the hospital, arrangements may be made through the social service department of the hospital.
  3. You may call our office and we will help you speak with your physician (814) 297-8400

Anyone can make a referral.  A friend, a neighbor, or you can even refer yourself.  If you believe someone you know might benefit from VNA services, please call us.  We will evaluate the situation and contact the physician for orders. 

 

If you are a referral source, the following information is needed by our intake department:

  • Patient’s name
  • Patient’s address
  • Patient’s phone number
  • Patient’s Social Security Number
  • Patient’s Birth date
  • Patient’s allergies if any
  • Medications
  • Diagnosis - if known
  • Admission & Discharge Dates
  • Type of Insurance(s)
    • Insurance Number
    • Group Number
    • Address of private insurance
  • Next of Kin Name and contact information
  • Primary Physician

Click here for a Referral Form (144 KB, pdf)

Please call or fax referrals to Clarion Forest VNA, Inc. at:

  • PH: (814) 297-8400
  • PH: (800) 262-2118
  • FAX: (814) 297-8800

The agency must have a physician’s order to provide care to a patient.  A patient will then be admitted for service with a physician’s order only if the VNA has the ability to provide safe, professional care at the level of intensity needed.

 

For language assistance click below: