Physician Referral Form
PHYSICIAN REFERRAL FORMS
Are you a Physician?
During COVID-19, all our services continue to operate using Telemedicine across Ontario.
To refer a patient, please download our referral form below and fax the completed form to 1-833-482-8999. Alternatively, you can complete our online e-referral and submit it directly through our website.
Please note that we cannot accept referrals for court or medico-legal purposes, and/or cases with unresolved custody/access issues.