"REFER-A-FRIEND" Referral Form

If you have had a good experience with Orthopaedic Rehab Specialists, we hope that you will "Refer a Friend" to us who might benefit from our patient-focused care and personalized treatments. 

Your Name *
Your Name
Your Phone number: *
Your Phone number:
Who referred you? *
Who referred you?
Please give us the name of the person that referred you to our clinics:
East Clinic- 206 Page Ave, Jackson West Clinic- 2136 Robinson Rd. Ste 1, Jackson Total Joint and Aquatic Center- 113 S. East Ave, Jackson Foot, Ankle and Running Center- 2797 Spring Arbor Rd. Ste B, Jackson Holt Clinic- 2040 N. Aurelius Ste 5, Holt Jonesville Clinic- 865 Olds Street Ste D-4, Jonesville Napoleon Clinic- 122 Brooklyn Rd, Jackson 49201
What is the best way to reach them?
What is the best way to reach them?
If phone is the best way to reach them, what number should we use to reach out to them?