Referral Form

Physician Referrals & Service Information

A physician's referral is NOT required to book an appointment or receive care at Kinema Physiotherapy & Sports Medicine. Patients are welcome to self-refer and schedule directly for any of our services at any time.

However, for physician offices wishing to refer a patient to our clinic, we provide a fillable PDF Referral Form. Medical clinics may download, complete, and submit this form directly to our administrative team via email at admin@kinema.ca or by fax at (289) 714-2712.

Download Referral Form
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Need to Book an Appointment?

Patients / Self-Referrals: Skip the paperwork and book directly online through our online portal or call us at (289) 816-4279.

Physician Offices: Use the button below to download our Fillable PDF Referral Form and send patient details directly to our clinical team via email at admin@kinema.ca or by fax at (289) 714-2712.

Download Referral Form