Patient Referral + Self-Referral
We accept referrals from healthcare providers and patients. If you have any questions regarding the below, please e-mail us at firstname.lastname@example.org or phone 587-997-4253.
HEALTH PROVIDERS: Please use the below form to refer a patient directly to our clinic, by inputting the patient's first and last name, including phone number. If you prefer to fax us a referral, please use the PDF requisition form
Fax Number: 587-705-0804.
SELF- REFERRAL: If you are referring yourself, please include your relevant contact information and any notes we should know. Please note that it is not mandatory to be referred by a healthcare provider, neither do you need a physician referral note, unless it is needed by your insurance provider for coverage.