Referrals

Submit Your Referral Form

Please select a referral form from the list below. You can choose between the Online version (submitted electronically) or PDF (to be printed and forwarded to Banyan Work Health Solutions’ Administrative Centre by email, at admin@banyanconsultants.com, or via fax to 416-588-9235 or toll free fax at 1-877-263-0123).

	Click Below
	PDF	Online
Banyan Referral Form – Employer Notification Form
Banyan Referral Form – Insurer Services Rehabilitation Case Management
Banyan Referral Form – Specialty Services
Banyan Referral Form – PillCheck™