Make A Referral
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Thank you for making a referral to Work Wellness. Please choose from the options below and we will contact you within 24 hours.

Referral Form for Work Wellness

This form will allow you to indicate what specific service would be of most service to you.

Full Name :

Company Name :

Address :

City :

State/Province :

Phone Number :

*Email :

Family Physician Inquiry

I am a family doc please contact me

Ergonomic Assessments

Office assessment

Physical Demands Analysis (PDA)

Industrial Ergonomic Assessment

Education topics

Lunch and Learn

Ergonomics 101

Train the Trainer

Back Health

Lifing 102

Bill C-45 and your responsibilities

MSD Guidelines Seminar

Return To Work

Return to Work Plan

Rehabilitation (onsite or at home)

Case Management

Functional Evaluation to determine if capable of returning to work

Motor Vehicle Accident Related

Functional Ability Evaluations

FAE

FCE

Post Offer Employment Test (POET)

On-site testing

Motor Vehicle Accident related

Professional Review

Corporate litigation

Expert opinion

Motor Vehicle Accident Related

External review of policies

Questions/Comments :

Please type 4135 into the text box

 


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