OBJECTIVE ASSESSMENTS, CONSULTATION AND EFFECTIVE TREATMENT


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Make a Referral

Which form is for you?
Making a Referral is easy! Simply look to see which form suits your needs then download, print and fax.

Before continuing, consider the following information as it could impact your decision to make a referral:

  • Link With Work does not offer any service that is funded by OHIP. Methods of payment include WSIB; automobile insurance, other insurance including extended health, self-pay, and employer pay.
  • For the Multiple Sclerosis Client Program, some funding is available through the MS Society, Kitchener Waterloo.

Are you a...

  • Physician
  • Employer
  • Chiropractor

    wishing to make a referral for physiotherapy services?


  • Insurer
  • Employer
  • Case Management Professional
  • Lawyer

    looking to refer to any of the other services listed on this site?


  • Physician
  • Chiropractor
  • WSIB Nurse Case Manager

    making a referral for a Multidisciplinary Health Care Assessment? (REC)


    (Note: clients who are referred for this assessment must be within a year of the original injury or recurrence)


  • Don't have Adobe software? To view or print these forms in a PDF you need Adobe Acrobat Reader. Please use this link & download.

    Contact us directly for more details or questions that you might have about our referral form and process.


    Unit 2, 101 Hazelglen Dr., Victoria Hills Plaza, Kitchener, Ontario N2M 5A2
    p:519 571 0642    p:519 571 0040    f:519 571 0013
    email: contact@linkwithwork.com