If you are a referral source: • Complete and fax our convenient referral form along with a demographic sheet with patient insurance information. If you do not have referral forms please call and we will supply them to you Or: • Fax a prescription/referral and a demographic sheet to the fax number listed below (i.e., P.T./O.T. evaluation and treatment, with diagnosis) • If you prefer, call our referral line to speak directly with our intake department. Phone/Referral Line: 1-877-407-3422 Fax: 1-877-407-4329 Fox is a Medicare provider, so if your patients have coverage, they will almost certainly qualify for treatment.