Instructions

To protect confidentiality of your client the referral forms can be submitted by fax, email or in-person. If you are not sure about which coverage you fall under, please feel free to choose the "Free Consultation" option. We will determine your eligibility upon your first visit.

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Our fax: 613-216-2156

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Referral Form Can be:

- Downloaded and electronically filled

- Printed and completed by hand

- used MDs, NPs, RNs and other providers

- used Patient for self-referral

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