The Referral Process

Referral to our rehabilitation centre happens when either a case manager or a health care provider completes the Referral for Admission Form and forwards it to Admitting Services. The completed Referral for Admission Form is forwarded to:

Admitting Services
WorkSafeNB's Rehabilitation Centre
P.O. Box 160
Saint John, N.B. E2L 3X9
Fax: 506 738-4467
Tel: 506 738-4323
Toll-free: 1 800 999-9775

Accommodations, if required, are provided at local hotels and can be arranged by Admitting Services. If required, these hotels provide shuttle service to and from the centre.

Information to be included with the referral form

The following items should be submitted along with the completed referral form:

  • Consultations and medical reports from specialists and family doctors
  • Operative reports
  • Summaries and reports from other treating facilities
  • X-ray and lab reports including CAT scan, myelogram and MRI reports
  • Reports from external therapists, including psychologists, chiropractors and physiotherapy clinics
  • Vocational rehabilitation reports and summaries
  • Appeals board reports and summaries
  • Regular physician's progress reports

Referral for Admission Form

Referral Form FAQs

1. Field: Referral for services
Please use this to indicate that the referral is for a client to be admitted to a service or program. Refer to the Programs and Services page of this website for details on specific referral options, and use that information to guide your program selection on the referral form. Indicate whether the client has a job to return to when treatment is complete.

2. Field: Supplies request
Please use this to request supplies for clients who do not need to be assessed as the supplies have been provided previously or the supplies have been recommended by another health care provider. Supplies will be provided without assessing the client. If the client needs to be assessed, then choose referral for service.

3. Field: Reason for referral/goal
Please use this area to give as much information as possible about the client. This will be used to guide the treatment team.

4. Field: Supplies required/authorized
Please use this area to give as much information as possible about the supplies authorized.

5. Field: Urgent admission
Please indicate if the client requires an urgent admission.

6. Field: Date client available for admission
Please specify the earliest date that the client will be ready for admission to the service or program requested.

7. Field: Language
Please indicate if the client can be served in English, French or either language. If the client speaks another language, please provide that information. This is used to determine team assignment.

8. Field: Re-admission
Please indicate if the client has previously been to the rehabilitation centre. (This is for statistical information and for treatment planning purposes.)

9. Field: Hotel required
Please indicate if the client is from out of town, and will be staying in a hotel. Accommodation arrangements are made by Admitting Services through discussion with the client. Accommodation costs are covered for injured workers through workers’ compensation benefits. (Those clients using the services through referral from a private insurance company should confirm with that company whether their accommodation costs are covered.)

10. Field: Is client job att?
Please indicate whether the client is job attached (has a job to return to when treatment is complete).

11. Field: Caution flag
Please indicate if the client has a caution flag on his file or has a history of abusive/violent behaviour towards staff.

12. Field: Diagnosis
This information should be taken from the most recent physician’s report. It should be as complete and detailed as possible.

13. Field: Completed by
Indicate the name and contact information of the person completing the referral form.

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