Would you like to make a referral to Hope Harbor?
The following four items need to be completed and faxed to 712.213.4034 for consideration of admission. Additional information will be requested upon provider approval.
- Copy of complete History and Physical within the past 6 months.
- Recent lab work: CBC, BMP and UA within two weeks of admission.
- Complete form list of attempted medical and non-medical interventions used including dates and outcomes for the past few days. Click to download the Hope Harbor Admission Form
- Copy of front and back of Medicare and other insurance cards.
Please call 712.213.8656 or email Hope.Harbor@bvrmc.org if you have questions or if there is anything else we can do for you. We want to make this process as easy as possible for you.
