Provide the Highest Quality Care

Clinician Referral

Our program is entirely OHIP Covered. We are currently only accepting referrals from a Clinician. At this time, we are not accepting self-referrals. If you are interested in our program, please ask your clinician to complete the form below. Thank you!

Eligibility: Age 18 or older.

All your data is safe with us, we do not share any of your personal information with any third party.

Birthdate

Reason for referral

Your details

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