Telephone/Fax Referral

A referral to Encore Unlimited for your Case Management needs is fast and easy!

- CALL and we will be happy to take the referral information over the telephone.

- FAX your referral to the service office closest to you, either by using Encore Unlimited's referral form or by providing your claim information.

-EMAIL your referral to encore@encoreunlimited.com by using your own electronic referral form or call the service office nearest you and request Encore Unlimited's electronic referral form.

Please also see our Secure On-line Referral section on this web-site. Simply complete the fields provided and hit submit. The referral is immediately received in our Referral Center. You will receive a call from the case manager assigned to your referral within 24 to 48 hours. Any pertinent medical materials you would like included, can be faxed to 800-536-5023 and will be forwarded to the case manager assigned to your referral.

Printable Forms
(For faxing referral information)

Request for Service Form - Adobe Acrobat (PDF format)
Requires Acrobat Reader -

Request for Service Form - MS Word Format