Request A Work Related Injury Service| Physiotherapy

Work Related Injuries Form

First Name & Last Name

Email

Address

Contact Number

WSIB Claim Number

Employer (Company and address)

Current Job Position and Length of Time in Current Job?

Immediate Supervisor, Contact Number?

Date of Injury

I Work

Full Time

Part Time

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Welcome to Professional Physiotherapy and Sports Clinic and thank you for choosing us to assist you with your health care needs.

Hours of Operation:

M-F: 7am-8pm

Saturday: available on demand
Sunday: closed

Phone: 613 689 9916

Fax: 613 689 3527