Use the button below to send all new referrals via our secure online portal:

Use the online referral form for the following:

  • Referrals from physicians (MD) and nurse practitioners (NP)
  • Referrals from therapists and counsellors (psychologists, psychotherapists, social workers, addiction counsellors, etc.)
  • Self-referrals (if you are seeking assistance and would like to connect directly with us)

If you prefer, you can also use the printed referral form below. Please fax the referral form or referral letters using your clinic’s standard EMR template to (416) 292-7656

General Referral Form