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Workplace Rehabilitation and Health Online Referral

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Worker Details

Origin
Interpreter required
Communication preferences or requirements
Access requirements

Referrer Details

Services Required

Service category

Claim Information and Diagnosis

Approved claim
Capacity

Documentation

Please provide a copy of any previous medical reports, certificate of capacity or any other relevant documentation, if available.

Click or drag files to this area to upload. You can upload up to 25 files.
Accepted file types: .xlxs, .jpg, .jpeg, .doc, .docx, .pdf, .png

Risks and Safety

Are there any court orders or legal proceedings applicable, e.g. child custody?
Has the participant ever been physically aggressive towards allied health, medical or support staff?
Has the participant been incarcerated in a prison, juvenile detention centre or spent time in a forensic hospital for a violent or sexual offence?
Is the participant currently engaging in alcohol or drug use?
Are there any known risks for visiting the participant in their own home?

Initial Assessment

Location of initial appointment
Are there any preferences for a consultant?

Service Agreement

Who will sign the service agreement

Payment Method

In addition to the payment provider, would you or another party like to receive the invoices?
Do you need a quote for service prior to proceeding?
Do you need a certain reference number or specific information on the invoice (e.g. PO number)

Further Information

Disclaimer

ORS will attempt to contact the nominated person in the referral from as soon as the referral has been processed to schedule an appointment at the earliest and most convenient time. If we are unable to contact you via telephone and you have indicated a preferred appointment day and time when completing the referral, we will do our best to schedule at, or around this time and send you an SMS and email with these details. If no appointment day and time were indicated on the referral form, we will need to make contact to confirm a suitable day and time for the appointment and will send you an SMS and email which can be responded to outlining preferred days and times. If we do not hear back from you within ten business days after attempting our first contact, we will be required to close the case to make space for other clients requiring ORS Services.

Disclaimer

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orsgroup.com.au | 1800 000 677