Skip to content
(250) 681-2317
peakkinesiology@gmail.com
3483 Wales Ave. Coquitlam BC V3E 0K5
Facebook-f
Home
About Peak
About Our Team
Referrals
Services
Cognitive Functional Capacity Evaluations
Return to Work Support Services
Post Offer Employment Testing (POET)
Ergonomic Assessments
Physical Demands Analysis (PDA)
Functional Capacity Evaluation (FCE)
Active Rehabilitation
Medical Legal Services
Contact
Resources
Blog
Physician’s Corner
Home
About Peak
About Our Team
Referrals
Services
Cognitive Functional Capacity Evaluations
Return to Work Support Services
Post Offer Employment Testing (POET)
Ergonomic Assessments
Physical Demands Analysis (PDA)
Functional Capacity Evaluation (FCE)
Active Rehabilitation
Medical Legal Services
Contact
Resources
Blog
Physician’s Corner
Referrals
Home
Referrals
Referral Source
Contact Name:
Contact Telephone:
Contact Fax:
Client Name:
Client Telephone:
Claim #:
Physician Name:
Physician Telephone:
Employer:
Employer Address:
Employer Contact:
Employer Telephone:
Services Requested:
One Day FCE
Two Day FCE
Cognitive FCE
Physical Demands Analysis
Job Site Visit
Return to Work Plan & Monitoring
Ergonomic Assessment
Post Offer Employment Testing
Active Rehabilitation Program
Active Rehabilitation Assessment Only
FCE Report Critique
Medical Review
Case Management
Other
Comments:
Send
