Patient Resources

Get Started with In Home Therapy!

You will be receiving electronic documents from Hellonote on behalf of Custom Care Rehab. Please fill these documents out before your evaluation. If you cannot receive electronic documents you are welcome to download your paperwork directly from this page, fill them out, and your therapist will collect the papers on the day of the evaluation.

If you cannot receive electronic paperwork, please, download and fill out the:

1.) 1st two pages of the  Notice of Privacy

2.) HIPAA

3.) Patient Intake Form

Your therapist will collect the papers on the day of the Evaluation

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Additional Forms