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Physician Referral Forms

Physician Referral Forms

Referral for Physiotherapy Consult

Do you need to refer your client for exceptional physiotherapy and related rehabilitation services!

At Alleviate Physiotherapy we offer a complete Referral Program with updates to all referring physicians over phone and email. (-  with Initial Assessment report / progress report ) 

Try our 15-Minute Screening / Phone Discussion with our therapist. Our Virtual Screening takes just 15 minutes. Our experts will educate and inform your patient about their proposed physiotherapy plan based on their mobility goals.

Please complete the following referral form. We shall contact your patient within 24-hours for screening with the appropriate physiotherapist.


For patient history and reports – email them to us at
info@alleviatephysiotherapy.com  or call us on + 1-416-613-8592

Physician Referral Form