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Ask For a Referral

You'll need a referral for rehabilitation services at Virginia Hospital Center. For more information, talk to your doctor or call us at 703.558.6507.

Registration, Forms & Insurance Information


To use Outpatient Rehabilitation services at Virginia Hospital Center, a written prescription or referral is required. All prescriptions and orders for therapy are only valid thirty (30) days from the date written. If your first appointment (the Evaluation appointment) is scheduled more than 30 days after your physician’s order was written, it is the patient’s responsibility to contact the referring physician to request an updated prescription (order) for the appointment. You cannot be seen for treatment if your prescription is more than 30 days old. Updated prescriptions (orders) can be faxed directly to the Outpatient Rehab Department at 703.558.5715.


Thank you for choosing the Virginia Hospital Center Outpatient Rehabilitation Department for your rehabilitation needs. Below are the registration forms required for your appointment. Please bring all completed forms with you to your first appointment. DO NOT mail completed forms.

For your first appointment, plan to arrive 20 minutes before your scheduled time. This will ensure adequate time to complete the registration process so that your appointment can begin on-time.

If you need assistance or are having difficulty completing the forms, please plan to arrive at least 30 minutes prior to your appointment time.

Failure to arrive at the necessary time prior to your scheduled appointment may result in rescheduling your appointment.

Please Remember to Bring:

  • Your Physician’s Prescription/Order
  • Insurance Card
  • Photo ID

Patient Forms

Required for All Patients:

Therapy Specific:

Insurance Information

  • Virginia Hospital Center Outpatient Rehabilitation Department participates with most major insurance plans. Please call 703.558.6507 to inquire about our participation with your insurance.
  • It is best practice for you to confirm with your health plan as well, to ensure that Virginia Hospital Center Outpatient Rehabilitation are in-network and determine if any additional referrals are required by your insurance.

Related Locations

  • Main Hospital
    Main Hospital


    1701 N George Mason Drive
    Arlington, VA 22205