© 2016 CAPRI Central Alberta Pain & Rehabilitation Institute

Physician New Patient Referrals 

Download, fill out and fax our referral request form or fax us your standard form to (403-782-6511). Be sure to include the patient’s name, date of birth, contact information, address and diagnosis.

Once your patient fills out our intake form, and we receive your referral and their imaging reports, our intake coordinator will call to book them in for an appointment for a comprehensive assessment.   

Including pertinent history about the patient you are referring into our clinic is appreciated. We will provide you with an assessment and subsequent treatment report after your patient's visit to our clinic. If you have any questions about our treatments, please feel free to call.