Referral Form
 

Medical management, rehabilitation and disability management.
(K&A) has been created and structured to meet your most pressing neurological disability and catastrophic case management needs serving Southeastern Ontario.

We specialize in assisting acquired brain injured and spinal cord injured individuals and their families.


  1. Knorr & Associates Referral Form

    PLEASE NOTE: Some web browsers may not process this form correctly. If you have difficulty submitting the form, please print it out and mail or fax to: Knorr and Associates Inc. RR# 1, Locust Hill, ON L0H 1J0 Fax: (905) 471-9799




  2. Select One




  3. Select One

  4. Client Information

  5. Assignment Information



















  6. Knorr & Associates Inc. is committed to quality rehabilitation intervention with the focus on assisting individuals in achieving their maximum level of physical and psychological functioning. In order to achieve this goal, co-operation of all parties is necessary and participation and feedback is essential. Upon receipt of this Referral Form by Knorr & Associates Inc., we shall fax back to you a letter of our understanding of this referral / assignment and request your confirmation in writing, prior to commencing this assignment.

  7. Confidentiality Notice: This information contained in this message is privileged and confidential information intended for the use of the addressee listed above. If you are neither the intended recipient nor the employee or agent responsible for delivering this message, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this in error, please notify us immediately by telephone to arrange for the return of the original document(s) to us. (905) 471-1699
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Knorr & Associates Inc. (K&A).
K&A offers a highly qualified staff of professionals who will strive to restore injured claimants back to their pre-MVA level of functioning, employment and/or school.
• Hospital Discharge-Planning
• In-Home Assessments

• Detailed Job Site Analysis
• Negotiate Graduated Return-to-Work/School Program

• Mobility assessments and ADP Qualified
 

Don't Text and Drive.

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