Patient Referral Form
Pacific Coast Recovery accepts patient referrals from:
- Insurance companies
- Lawyers
- Doctors and other health care professionals
- Union representatives
As well, if you are a patient in need of serious injury / illness recovery care, please fill out the form below to help us assess your situation.
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Patient Referral Form
If you are a patient and require information to be released to your lawyer, please complete the following Release Form and submit it to our office.
How to Submit Documents to our Office
Deliver to:
Pacific Coast Recovery Care
BURNABY SQUARE
Unit 202 – 7885 6th Street
Burnaby, B.C. V3N 3N4
Fax to:
604-525-8124
Email to