Connecting You to Quality Care

Whether you’re a healthcare provider or a patient, our simple referral process ensures quick access to expert physiotherapy at home.

Referral Form

Patient Information

Name

Phone Number

Email Address

Diagnosis / Recommendations

In-Home and Virtual Services

Physiotherapy Massage Therapy Naturopathy / Acupuncture Chiropractic Osteopathy Aquatic Therapy

Speciality Programs

MVA Rehabilitation (Motor Vehicle Accident) Osteoporosis / Bone Strengthening Pregnancy Pre / Post Natal Care Pelvic Floor Health Post Injection Rehab Stroke Rehab Active Therapy WSIB Arthritis / Early Intervention OA Concussion Assessment and Management Fall Prevention Low Back Pain Program Lymphedema Treatment Sprains and Fractures Program

Doctor's Name (optional)

CPSO Number (optional)

Signature

Patient Information

Name

Phone Number

Email Address

Diagnosis / Recommendations

In-Home and Virtual Services

PhysiotherapyMassage TherapyNaturopathy / AcupunctureChiropracticOsteopathyAquatic Therapy

Speciality Programs

MVA Rehabilitation (Motor Vehicle Accident)Pregnancy Pre / Post Natal CarePost Injection RehabActive TherapyArthritis / Early Intervention OAFall PreventionLymphedema TreatmentOsteoporosis / Bone StrengtheningPelvic Floor HealthStroke RehabWSIBConcussion Assessment and ManagementLow Back Pain ProgramSprains and Fractures Program