Make a ReferralReferral Form Use this form to refer a worker case to Pinnacle Rehab. Click here for a printable PDF version.Referrer DetailsCompany Representative Name* First Last Company Name*Phone*Email* Type of Service Required*Client DetailsClient Name* First Last Claim Number*Client Home Suburb*Employer DetailsEmployer Name First Last Company NamePhoneEmail Agent / Insurer DetailsAre the Agent/Insurer details the same as the Referrer details?*YesNoContact NameCompany NamePhoneEmail Team NumberRegionSydneyParramattaNewcastleWollongongTamworthCentral CoastOtherSupporting DocumentsFile UploadTo expedite your referral, Please attach the following documents:1. Referral form (if available) 2. Medical Certificate Documentation 3. Any supporting documents Drop files here or NameThis field is for validation purposes and should be left unchanged. Pinnacle Rehab have helped thousands of workers and employers each year, using a collaborative approach to injury prevention and rehabilitation. Call us now on 02 8424 6700.