To visit our clinic, we first require a referral from your physician. We have tried to make this process as simple as possible and it is required for our services to be covered by OHIP.

Please have your physician fill out the following form for you.

Referring Physicians, please note:
Any relevant attachments can be faxed to 289-835-3428.

*FHO, FHT patients will need to request they be temporarily de-rostered by their current GP – this is administrative only and does not affect your status with or care provided to you by your current GP.

*We will automatically receive a copy of the online form below. If you prefer, you can alternatively print a PDF version and fax it to 289-835-3428. Click here to download the PDF version for Print as an alternative to filling out the online form below.