Private Day Rehabilitation Referral Form

Day Rehabilitation

Royal Rehab Private Hospital (RRPH) Day Rehabilitation offers innovative evidence-based programs, on-site hydrotherapy and a dedicated multidisciplinary team of professionals committed to helping patients achieve their goals. Our skilled and professional team include rehabilitation specialists, physiotherapists, exercise physiologists, speech pathologists, occupational therapists, dietitians and nurses. RRPH Day Rehabilitation is a leading facility of choice for those not requiring overnight inpatient nursing and medical care. Individually tailored programs are developed for patients based on mutually agreed and meaningful goals.


Patient Details


Address


Contact


Details

Interpreter Required?*


Next of Kin


Health Fund Details


Referrer Details


Primary Diagnosis


Current Status


Services Required

Minimum of 2 disciplines. Half Day Program: 1.5 hours, Full Day Program: 3 hours.

Hydrotherapy

Dietetics

Exercise Physiology

Occupational Therapy

Physiotherapy

Speech Pathology

PD Warrior

LSVT BIG

LSVT LOUD

Is Hydrotherapy recommended as part of client's rehabilitation program? If so a hydrotherapy clearance form will need to be signed by a medical officer.*


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