For Healthcare Providers

Upload Referral Documents

Download and complete our referral form, then upload it here along with any supporting documents such as lab results or imaging.

Referring Physician

Physician Name

Clinic Name

Phone

Fax

First Name

Last Name

Date of Birth

OHIP Card Number

Version

Phone

Email (optional)

Attach the completed referral form and any supporting documents such as lab results or imaging reports.

Drop files here or browse

PDF, JPEG, PNG · Max 10 MB per file · Max 50 MB total

Questions? Contact us at [email protected]