Penawar Rehabilitation Centre

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alliedhealth@hospitalpenawar.com +6016 733 7466 / +6016 723 1171

Penawar Rehabilitation Centre

Delivering comprehensive, evidence-based rehabilitation through a multidisciplinary team dedicated to restoring function, enhancing recovery, and improving quality of life across all age groups

Contact Info

No 15-19, Business Center, 228, Jalan Bandar, Kawasan Perindustrian Pasir Gudang, 81700 Pasir Gudang, Johor

alliedhealth@hospitalpenawar.com
+6016 733 7466

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Home
About Us
Services
Event
Refferal
Appointment
Contact

Referral Form

Please fill in the referral details below.

Patient & Referral Details

Name *

Date of Birth

IC/Passport

Contact No

Email *

Address

Clinical Information

Diagnosis / Condition

Discipline Referral (Tick as Required)

Physiotherapy

MSK (Back/Neck/Joint)

Musculoskeletal Injury

Post-Surgery

Pain Management

Geriatric

Gait Training

Balance & Fall Prevention

Occupational Therapy

Return-to-Work Programme

Functional Capacity Evaluation

Neurological Rehabilitation

ADL Training

Hand Therapy (Post-Fracture/Tendon Injury)

Splinting & Orthotics

Hand Function Retraining

Audiology

Audiometry Test (Diagnostic/Industrial)

Tympanometry Test (Middle Ear)

Newborn Hearing Screening

Hearing Aid (Trial/Fitting)

Dietetics

Diabetes Management

Weight Management

Cardiac / Renal Nutrition

Sports Nutrition

Clinical Nutrition Support

Medical / Neuro Rehab

Stroke

Parkinson's Disease

Spinal Cord Injury

Chronic Disease Management

Sports Medicine

Return to sport (RTS)

Sport Injury management

Sport Massage

Taping / Strapping

Prenatal Pilates

Psychology

Psychological Assessment

Stress / Anxiety Management

Grief & Loss

Family / Social Support

Speech Therapy

Speech Delay

Language Disorder

Dysphagia

Communication Disorder

Others:

Referring Doctor

Name

Clinic/Hospital

Contact

Doctor's Email (filled form will be sent here)

Date

* By submitting this form, you acknowledge that the information provided is true and accurate.

Our team is here to assist you. Reach out to us and we’ll respond as soon as possible.

Address

No 15-19, Business Center, 228, Jalan Bandar, Kawasan Perindustrian Pasir Gudang, 81700 Pasir Gudang, Johor

Phone

+6016-733-7466
+6016-723-1171

E-mail

alliedhealth@hospitalpenawar.com