REFERRAL REQUESTS Request a referral Are you a claims adjuster looking to refer an injured worker to CompRehab? Contact us for a workers’ compensation statutory rehabilitation referral request by filling out the form below and we will get back to you shortly. Name* First Last Address* Street address Address line 2 City State ZIP Phone*Email* Services requested (check all that apply)* Rehabilitation consultation (eligibility determination) Statutory vocational rehabilitation Medical case management Functional job analysis Recommendations for job modifications Ergonomic workstation evaluation Job coaching Additional information (optional)CAPTCHA