CONTACT ARC HEATH

No doctor or specialist referral is necessary.
Please contact us via phone, fax or email to discuss assessment and treatment options.
We take referrals from:

  • Patients
  • Family, friends and carers
  • Allied health professionals
  • Doctors and specialists
  • Case managers and injury claim consultants

GENERAL ENQUIRIES  : office@archealth.com.au

REFERRAL FORM

Printable Referral Form - click here

NAME OF CLIENT
 ADDRESS
D.O.B
 INSURANCE COMPANY
PHONE
 INSURANCE CLAIM No#
EMAIL ADDRESS
 INSURANCE CONTACT PERSON
THERAPY REQUIRED
DIAGNOSIS
REASON FOR REFERRAL
RELEVANT MEDICAL HISTORY & MEDICATION
TREATING DOCTOR
PHONE/FAX
PROVIDER No
FAMILY CONTACT
RELATIONSHIP
PHONE
HOW DID YOUR HEAR ABOUT ARC ?