Cottage Pain Clinic - Eligibility

 

Current Physicians, Nursing Practitioners, (either an individual medical family practice or referring physician) can refer Clients in the following ways:

1. Mail the prescription for "Pulsed Magnetic Therapy" and completed Physician, Nursing Practitioner Referral Form requesting their patient receive Cottage Pain Clinic's Masor® treatment to:

Cottage Pain Clinic, 4668 Hwy 518 W. R.R.#1, Sprucedale, ON P0A 1Y0
Office Phone :
2. Fax: if prearranged through the office. Click on the form below.

PDF Form

3. Completed Physician, Nursing Practitioner Referral and prescription given directly to the Patient. See above PDF Form above.

Note: This is a specialized chronic back pain relief treatment program which can partner and collaborate with health professional multi-disciplinary teams. Cottage Pain Clinic may make arrangements for the mobile pain service on a case by case basis, or offer offsite clinics in partnership with organizations/professionals in the health care industry. Once a completed referral and prescription has been recieved and accepted, treatment fees of $8.00/minute apply and the minimum time of 45 minutes. Treatment is not covered under the Ontario Health Insurance Plan. A consultation fee of $90.00/hour, (ninety dollars per hour) is charged when requested. Report fees are $90.00/hour, (ninety dollars per hour) for Third Party, Physician or Nursing Practioner requests. These criteria and fees apply to Occupational Insurance referrals. Fees are due post treatment session or through third party financial arrangements. Cottage Pain Clinic's mobile service charges travel costs outside the 25 km radius of our office location. Km rate is $0.55/km. See Visit page for standard treatment and follow-up guidelines.

Cottage Pain Clinic Service Inclusions

1. Clients over 18 years of age or those with Physician/Nursing Practitioner referral and parental consent(s) on a case by case basis.
2. Clients who are medically stable.
3. Children may be treated with parental consent and physician's prescription based on the same eligibilty requirements
4. Individuals with a physical impairment who have been prescribed Masor® treatment for chronic back pain relief.
5. Individuals with identified goals for pain relief and the completed Physician/Nursing Practitioner Referral Form (see downloadable PDF)
6. Case by case for individual treatment through the mobile Cottage Pain Clinic service.
7. Out of area Clients may be referred for treatment if visiting and arrangements are confirmed in advance.
8. Must be under the continuing care and participation of a Physician and/or Nursing Practitioner.

Cottage Pain Clinic Exclusions for Service

1. Medically unstable Clients unless prescribed for palliative pain relief.
2. No part of this specialized treatment service is intended for use in legal proceedings and/or medical legal purposes.
2. Clients under the age of 18 without the applicable criteria from the physician and parental consent(s).
3. Clients with behavioral, cognitive, or mental health issues that would interfere with treatment participation.
4. Clients whose primary pain symptom is headache, pelvic pain or pain related to gastrointestinal, urinary or gynecological problems.
5. Clients who are seeking prescriptions, epidermal blocks or other medical assessment or treatment.

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Other Multidisiplinary Services

Clients may wish to pursue a physiatrist assessment, or to consider evaluation by a physical rehabilitation specialist in the community for other multidisciplinary service implications. For a list of Physical Medicine and Rehabilitation specialists, search the database on the Web site of the College of Physicians & Surgeons of Ontario (click on Doctor Search -- Advanced Search)

Disclaimer

"No part of this website may be reproduced by any method (electronic, verbal, written or fax) or used for any other purpose such as medical/legal matters, (except the Physcian/NP Referral Form). The information contained in this format is dealing with a more broad discussion of service, processes which may or may not arise. Each document or information provided is taken on its own merits and the presumed truthfulness of the parties involved. Cottage Pain Clinic, formally Cottage Day Spa reserves the right to take action where required if this condition is breached."