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E-Referral


Want to send us a referral?

Just fill-up the form.

Simply select the type of assistance you require, completing the mandatory fields and send to IHS by cllicking the submit button below:

The fields marked with * are required fields.

Injured Worker Details
Injury Details
Employer
Insurer
Nominated Treating Doctor
Specialised Services Required (please tick)*
Comments
Referral Details
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