COVID-19 UPDATE
About Us
About Us
Meet the Team
Services
Exercise Prescriptions
Worker's Compensation / Motor Vehicle Accident
Corporate Health
Hydrotherapy
Forever Fit
Life Now (Dot's Place)
Pre-Employment Medicals
National Disability Insurance Scheme (NDIS)
Billing
Private Health
Medicare
Department of Veteran Affairs
Achievements
Contact Us
COVID-19 UPDATE
About Us
About Us
Meet the Team
Services
Exercise Prescriptions
Worker's Compensation / Motor Vehicle Accident
Corporate Health
Hydrotherapy
Forever Fit
Life Now (Dot's Place)
Pre-Employment Medicals
National Disability Insurance Scheme (NDIS)
Billing
Private Health
Medicare
Department of Veteran Affairs
Achievements
Contact Us
Maximum Results Exercise Physiology Pty Ltd
Address: 181 Spencer Street Bunbury WA 6230
Postal Address: PO Box 696 Bunbury WA 6230
Phone: (08) 9792 4179
Fax: (08) 9791 4379
Email:
exercise@maxresults.com.au
Opening Hours
Monday - Thursday 7:00 AM - 5:30 PM
Friday 7:00 AM - 5:00 PM
Stay ahead of time and complete the following forms prior to your Initial Consultation:
Health Screen Questionaire
Consent To Exercise Physiology
For any inquires please call us or complete the forms below:
E-Referral
E-Referral
1. Personal Details
Name
*
First Name
Last Name
DOB
*
MM
DD
YYYY
Select
*
Other
Female
Male
Mobile No
*
Home No
Email Address
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
2. Injury Details
Date of Injury
MM
DD
YYYY
Describe Injury
3. Employment Details
Employer
Insurer
Claim Number
4. Referral Details
Referred By
Referrer Email
5. Comments
Comments
Thank you!
Contact Us
Contact
Name
*
First Name
Last Name
Email Address
*
Subject
*
Message
*
Thank you!
