Referral Form

You may refer patients to our office by filling out our Referral Form. Please fax the completed form to 416-225-9889 and give the original copy to the patient to bring to their appointment. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Technical Note:

You need Adobe Acrobat Reader to view our form. Please download the free Acrobat Reader from Adobe’s web site if it is not already installed on your system.