Online Referral Form

We offer two methods for submitting an occupational therapy referral.  You can complete the fully secured online referral form below or, alternatively, you can use our downloadable PDF form and send via fax or email.

Occupational Therapy Referral – PDF form

The PDF form can be accessed here. Please print out the PDF form, fill it in, and either fax back to us on (08) 8331 0277 or email to admin@livingtothemax.com.au.

Occupational Therapy Referral – Online form