Make a Referral

Anyone can make a referral to Origami. To make a referral or request an appointment, please submit the online form below. You may also fax, email, or call the Origami Admissions Team to get started. Be prepared to answer questions about the individual's contact information, diagnosis or deficits, rehabilitation goal, medical history, and all possible insurance plans.

Admissions Contact Information

Phone Number: 517-455-0264

Email: info@origamirehab.org

Fax Number: 517-252-2670, Attention: Admissions

Payment Information

We accept funding from many sources. Our admissions team will help you navigate this process and will find a payment method that works for you.

Learn More Funding Sources

Online Referral Form

Preferred Location

Potential Client Name

Phone Number

Date of Birth

Date of Injury

Client Address

City

State

ZIP/Postal Code

Person/Provider Making the Referral

Name

Relationship to Client

Phone

Reason for Referral

What is the diagnosis or deficit?

What is the rehabilitation goal or desired outcome?

Is the individual receiving services elsewhere? If yes, what service and where/with whom?

What are the individual's insurance plans?

Origami does not deny admission or discriminate against any individual because of race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or marital status.