To request for Home infusion services from D&S Home Care Agency, please choose from the following options:
Click on "Download" button below to get Intake *PDF form.
The form will open in your browser and you can also save blank form on your computer.
1) Fill out the form right on your computer and print it, then fax or mail it to the Agency.
2) Print the blank copy, then fill it out with black ink pen then fax or mail it to the Agency.
Our Fax Number is 516-825-0508 and our mailing address is:
D&S Home Care Agency, LLC
211 Broadway, Suite 301
Lynbrook, NY 11563
3) Contact us by calling 516-717-4447.
When you call us, please have the following information available:
- Patient Name, Address, Contact Number & Insurance/member number
- Patient's Private Physician name and phone Number
- Primary Diagnosis
- Patient H&P
- MD's order for home care services
- Discharge Summary
- Discharge medication list
- Alternative number where you can be reached
Our Patient care coordinator is available for your assistance, please feel free to contact us at any time.
Our Licenses:
Pending New York State Department of Health license for Home infusion. We are member of National Association of Home Care Organizations.
The community may contact the local and state Office of Quality Monitoring to register any complaints or concerns at 800-804-5447
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