How To Get Started

STARTING THE PROCESS

(Click the UNDERLINED LINKS below to view or print forms) 

1 - Download, fill out, and e-mail or fax back the following form: 

- Driver Evaluation Request (Word) or (Mac/Pages Version) -

    * If you prefer to fill it out by hand, you can download the 'PDF' document here and fax or mail it back.

2 - Contact your physician and request a referral/prescription for a 'Drivers Evaluation'.  Just print out the pre-printed 'Physician Referral' form and provide it to the doctor. The return fax number is on the form.

3 - Review and return the following form:    - Client Consent, Contract & Release of Information -

(This can be done via e-mail, fax or/and provided at the time of service)

Once the Physician Referral & Driver Evaluation Request are received you will be contacted to arrange an appointment date & time.

Please Note: Cancellation of appointment with less than 48 hours notice will be charged a $100 cancellation fee.   

http://bcert.me/plbugufr