Moving Towards Wellness Ltd. - Rehabilitation - Vocational

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ONLINE REFERRAL FORM

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Extended Health Insurance Yes No

Insurance Carrier
(if known)

Section 42 Insurers Examination Yes No

Services Required - check off the appropriate service(s)

Catastrophic Case Management
ABI, SCI, Complex orthopaedic, Amputation

Medical & Rehabilitation Management
(Non-Catastrophic, Personal Injury)

Discharge Planning

Life Care Plan

Adjustment Counselling (Social Work)

Rehabilitation & Recreation Therapy

Vocational Consulting and Assessments

Return to Work Planning & Facilitation

Ergonomic Assessments and Implementation

Job Site Assessments with Physical Demands Analysis

Education (Lifestyle and Pain Management)

Functional Capacity Evaluation

Medical Information Review

Training & Education Workshops

In-Home Assessments

	Assessment of Attendant Care
	Activities of Daily Living

Active Exercise Therapy Programs

	Home
	Community-Based
	Aquatic Rehabilitation

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