Day Referrral

Royal Rehab Private Hospital (RRPH) Day Rehabilitation offers innovative evidence-based programs, on-site hydrotherapy and a dedicated multidisciplinary team of professionals committed to helping patients achieve their goals. Our skilled and professional team include rehabilitation specialists, physiotherapistsexercise physiologistsspeech pathologistsoccupational therapists, dietitians and nurses.

Complete the referral form below

Our Day Rehabilitation is a leading facility of choice for those not requiring overnight inpatient nursing and medical care. Individually tailored programs are developed for patients based on mutually agreed and meaningful goals.

You can contact Day Rehabilitation on (02) 9808 0522 or email us.

"*" indicates required fields

Date of Referral*
Discharge Date (If applicable)

Patient Details




Date of Birth*
Interpreter Required?*

Next of Kin

Health Fund Details

Referrer Details

Primary Diagnosis

Current Status

Services Required

Minimum of 2 disciplines. Half Day Program: 1.5 hours, Full Day Program: 3 hours.

Exercise Physiology
Occupational Therapy
Speech Pathology
PD Warrior
Is Hydrotherapy recommended as part of client's rehabilitation program? If so a hydrotherapy clearance form will need to be signed by a medical officer.**
Will transport be required?*