New Jersey Facility Network

New JerseyFacility Network

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 TitleDescription
Facility Key Telephone NumbersThe phone and fax numbers for reaching the LogistiCare Facilities department.
New Jersey Closest Provider Certification FormClosest Provider Certification Form for New Jersey
New Jersey Closest Provider PolicyClosest Provider Policy for New Jersey
NJ Child Consent FormNJ Child Consent Form
NJ Physician Medical Necessity Form - wheelchair and BLS (stretcher)NJ Physician Medical Necessity Form - wheelchair and BLS (stretcher)
NJ Physician NJ Physician Medical Necessity Form - Ambulatory or Mass TransitNJ Physician NJ Physician Medical Necessity Form - Ambulatory or Mass Transit
NJ Physician NJ Physician Medical Necessity Form – Specialty Care Transport (SCTU) onlyNJ Physician NJ Physician Medical Necessity Form – Specialty Care Transport (SCTU) only
NJ Single Trip RequestNJ Single Trip Request
NJ Standing OrderNJ Standing Order

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