CORE Medical Centre Referral Form

Please download, complete and email or fax the form below if your client or employee requires one or more of the following assessments:

  • Independent Medical Exam (IME)
  • Functional Capacity Evaluation (FCE)
  • Cost of Future Care (CFC)

Who should use this form?

This form is for referrals from:

  • Lawyers
  • Insurance companies
  • Employers
  • Unions

Fax to 604-525-8124
Email to

CORE Referral Form (WORD)

CORE Referral Form (PDF)

CORE Medical Centre
Unit 202 – 7885 6th Street
Burnaby, BC
V3N 3N4
Phone: 604-525-8604
Fax: 604-525-8124