Embedded Files
STARTING THE PROCESS
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)
Consent, Contract, Release.pdfOnce the Physician Referral & Driver Evaluation Request are received you will be contacted to arrange an appointment date & time.
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.
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