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Refer a Patient & Eligibility

What makes you an 'eligible patient'?

If you are home bound, not bedridden, in need of medical assistance.

If you have a disability or illness that requires skilled care.

Not sure of your eligibility? Call us at (630) 893-9010, or ask your doctor. Your doctor will give you a written recommendation based on your status and condition. 

Patient's First & Last Name*

Patient's Email (if any)

Patient's Phone Number*

Name of Referrer

Referrer's Contact Information

Doctor's Name*

Doctor's Contact Information*

If you, or a loved one is interested in Excellent Care Health Services, call us or talk to your doctor, submit the requested information, and we will get back you as soon as possible.

This info will be sent to our company email and will only be used for getting in touch with the patient's doctor. We assure you that this info will remain confidential. 

Excellent Care Health Services Inc.

ADDRESS: 400 West Lake Street, Suite 306, Roselle, IL 60172

PHONE: (630) 893- 9010, FAX: (630) 893- 9017, EMAIL:

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