Patient Referral + Self-Referral
We accept referrals from healthcare providers and patients. If you have any questions regarding the below, please e-mail us at email@example.com or phone 587-997-4253.
HEALTH PROVIDERS: Please use the below form to refer a patient directly to our clinic, by inputting the patient's first and last name, including phone number. Please note that information sent via below box or e-mail to firstname.lastname@example.org is only viewed by the practicing Physiotherapist. If you prefer to e-mail or attach a requisition form, please see our PDF requisition form, fill out and return via email.
SELF- REFERRAL: If you are referring yourself, please include your relevant contact information and any notes we should know. Please note that it is not mandatory to be referred by a healthcare provider, neither do you need a physician referral note, unless it is needed by your insurance provider for coverage.