Schedule an Outpatient Rehabilitation Appointment

Submit an online form to schedule an outpatient rehabilitation appointment at Adventist HealthCare, or ask your primary care doctor for a referral.

To request an Adventist HealthCare Rehabilitation outpatient appointment, please complete the form below or call 240-864-6202.

* Denotes required fields.

Patient Information

* I'm a...

* First Name

M.I.

* Last Name

* Address

* City

* State Example: NY

* ZIP Code Example: 12345

* Phone Example: 555-123-1234

* Email

Please add me to your email list to receive related health news and event information.

* Date of Birth (mm/dd/yyyy)

* Gender

* Insurance Plan

Please select a service and preferred day/time for your appointment and we will do our best to accommodate your request.

* Requested Service

* Preferred Day

* Preferred Time

* Is this appointment related to a Workers’ Comp, MVA or No Fault Case?

* How Did You Hear About Us?