Day Program
Our Royal Rehab Private Hospital Day Program specialises in:
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Stroke recovery
Neurological
Orthopaedic
Post-spinal surgery
Reconditioning
rehabilitation.
Our program is ideal for those with rehabilitation goals not requiring overnight inpatient nursing and medical
care. We offer the following individually tailored high-intensity therapy programs in modern state-of-the-art
facilities:
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Hydrotherapy
Clinical Psychology
Orthopaedic Clinic
Dietetics
Communication Group
Stroke Survivors
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Exercise Physiology
Cognitive Group
Falls Prevention
Occupational Therapy
Energy Conservation
Neuro Clinic
Nursing
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Relaxation
Physiotherapy
Upper Limb Group
Social Work
Recreational Therapy
Speech Pathology
The duration of the Day Program is determined by a multidisciplinary treating team under the direction of a
rehabilitation specialist and consists of either full or half-day therapy sessions. We also offer sessional
therapy to clients requiring a single mode of therapy.
Therapy groups are capped at a maximum of eight patients per clinician and all individual sessions are oneto-one.
Cost:
Varies depending upon level of private health insurance cover.
Eligibility: Royal Rehab Private Day Program Referral form (refer to other side) or doctor’s referral letter.
Day Program
235 Morrison Road
Ryde NSW 2112
PO Box 6
Ryde NSW 1680
E. referrals@royalrehab.com.au
T. (02) 9808 0527
F. (02)8088 4316
Day Program Referral
(PDPR.615)
MRN _________________
GIVEN NAME _______________________
MALE
DoB _______/_______/_______
FEMALE
M.O.____________________________
ADDRESS ___________________________________________________
235 Morrison Road, Ryde NSW 2112
PO Box 6, Ryde NSW 1680
E. referrals@royalrehab.com.au
F. (02) 8088 4316
BARCODE
FAMILY NAME _____________________
_____________________________________________________________
LOCATION/WARD __________________________________________
COMPLETE ALL DETAILS OR AFFIX CLIENT LABEL HERE
Date of Referral: _______________________________________ Discharge Date (if applicable): ________________________
Patient Details
Name: _____________________________________ DOB: ________________ Tel: _________________________________________
Address: __________________________________________________ Interpreter required: Yes / No
Binding Margin – No Writing
Next of Kin: _______________________Relationship:______________ Tel: ______________________________________________
Health Fund: ____________________________
Membership No: ___________________________________________
Workcover / CTP / DVA: _____________________ ____________________ Claim No: ___________________________________
Referrer Details:
Referrer’s Name: ____________________ Facility: ____________________ Tel: _________________________________________
Specialist/Surgeon/GP: __________________________________________ Tel: _________________________________________
Primary Diagnosis: Operation Date:
/
/ Weight Bearing Status: ______________________________________
__________________________________________________________________________________________________________________
Relevant Medical History (including Allergies/ Alerts: _____________________________________________________
__________________________________________________________________________________________________________________
Current Status:
Cognition: _____________________________________________________________________________________________________
Communication: ______________________________________________________________________________________________
Day Program Goals / Reason for Referral:
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Services required: (minimum of 3 sessions; 3-5 sessions =half day; 5+sessions = full day)
Requested duration of program: _________________________________days/weeks
Days that patient is unavailable to attend: Mon am/pm, Thur am/pm, Fri am/pm
INDIVIDUAL THERAPIES
Therapies
Duration
(min)
GROUP THERAPY
Frequency
Classes
Clinics
Clinical Psychology
30 / 60
Hydrotherapy
Ortho Clinic
Dietetics
30 / 60
Communication Group
Stroke Survivors
Exercise Physiology
30 / 60
Cognitive Group
Falls Prevention
Occupational Therapy
30 / 60
Energy Conservation
Neuro Clinic
Nursing
30 / 60
Relaxation
Physiotherapy
30 / 60
Upper Limb Group
Social Work
30 / 60
Recreational Therapy
30 / 60
Speech Pathology
30 / 60
NO WRITING
Private Day Program Referral
Binding Margin – No Writing
Mobility/Transfers: ___________________________________________________________________________________________