Referral Form
Please
download our Referral form if you are interested in the provision of any of the following Rehabilitation services:
- Worksite Assessment
- Workstation Assessment
- Activities of Daily Living Assessment
- Job Analysis
- Graduated Return to Work Plan
- Job Dictionary
- Doctor’s Letter
- Functional Matching Matrix
Click here to download.
Once downloaded, the form can be completed electronically, saved to your local PC and then emailed to
pinnacle@pinnaclewc.com.au. Alternatively you can print and complete the form, then fax to us on 8271 2212.
Please
contact us if you would like further information.