Referral Network Application

Thank you for considering this. Before anything else, here is the part that matters most to you professionally. There is no payment involved anywhere in this arrangement.

Members of the Referral Network receive no commission, no rebate, no revenue share, no bonus and no gift, in any amount, at any time. We built it this way because physiotherapists, chiropractors, kinesiologists, psychotherapists, lawyers and paralegals all work under conflict of interest standards that restrict or prohibit taking a commission on a product recommended to a patient or client. Rather than ask you to work out where that line sits inside your own college's rules, we removed the money. There is nothing here for you to declare as a financial interest, because there is nothing to declare.

What you receive

  • A code giving your patients or clients 15 percent off any Hurt Square guide. The discount belongs entirely to the person buying it.
  • One complimentary copy of the guide for your province and practice area, kept for your own reference.
  • A printed one page insert, sized for intake folders and discharge packages.
  • An optional listing in our public directory of participating organizations.

What to include

Copy the block below into the message field and fill it in.

Organization name:
Your name and role:
Email:
Address, city, province or territory:
Practice type, for example physiotherapy, personal injury law, case management:
Your regulatory college or governing body, if you have one:
Roughly how many injured patients or clients you see in a month:
Would you like a directory listing, yes or no:

One thing we ask in return

Please never send us patient or client information of any kind. The code works without it, we do not want it, and we will not accept it. Anything a purchaser tells us, they tell us themselves. This keeps your privacy obligations clean and ours simple, which is better for everyone including the person in your treatment room.

Before you apply

Please read the Referral Network Agreement. Submitting an application confirms that you accept it. You may withdraw at any time, for any reason, with no notice period, no minimum and no obligation to have referred anyone at all.

If you would rather ask a question before applying, write to Recovery@hurtsquare.ca.

Hurt Square

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