Service Request
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Port MacquarieKempseyCoffs HarbourOther
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1) Please Select Allied Health Professional(s) Required:
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2) Please Select Funding Source
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Accredited Exercise PhysiologistAccredited Exercise ScientistHealth Care AssistantPhysiotherapistOther:
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Private PatientPrivate Health InsuranceCTPDepartment Veteran AffairsEmployerWorkCover (<em>please attach medical certificate</em>)Lifetime Care & Support – IcareWorkers CareLife InsuranceBetter StartNDISMedicareOther:
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3) Please select specific program/service (optional if known)
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Integrated Care Programs:Persistent Pain Program (WorkCover/CTP/DVA)Work Conditioning Program (WorkCover)Corporate Programs:Manual Handling Training (WorkCover and Corporate)Specific Assessments:Gait Scan Assessment & Orthotic PrescriptionMetabolism Assessments, Indirect CalorimetryPre-Employment ScreeningWorkstation Ergonomic AssessmentFunctional Capacity EvaluationWorkplace AssessmentFunctional Independent Measures (FIMS)WEEFIMSCare and Needs Assessment & ReviewCare and Needs Scale (CANS)Pediatric CANSCase ManagementClinical Gait AssessmentBike FitNeurorehabilitationVo2 MaxVo2 Sub MaxIndirect CalamityOrthotics PrescriptionWorkCover NSW (please attach medical certificate)Physiotherapy TreatmentExercise Physiology Treatment
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