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Refer a patient

For physicians, nurse practitioners and allied health. Two minutes online, or fax. Your patient hears from us within one business day.

Fastest

Online

Refer in two minutes

Tap the concerns, add a line of notes, done. Confirmation and reference number by e-mail.

Start the form

Fax

289-203-3071

Any referral letter works. Include the patient's phone number and your fax for the summary.

Printable referral form (PDF)

Phone

905-635-5711

Ask for the concussion team. Good for a quick question about whether a patient is a fit.

Monday – Friday: 9am – 5pm

One business day

We call your patient to book. You get an e-mail confirmation with a reference number.

Seen within the week

Two physiotherapists with advanced concussion and vestibular training. Urgent referrals are triaged the same day.

A summary back to you

Our assessment summary is faxed to your office after the first visit, and again at discharge.

Billing handled

Direct billing to extended health plans; motor vehicle claims billed to the auto insurer. No paperwork for your office.

Online referral

Three short sections. Nothing to print.

01

About you

So we can confirm receipt and send your patient's assessment summary back.

02

About the patient

We call the patient directly to book. Name and a phone number are all we need.

03

The concussion

Tap what applies. A sentence or two of notes is plenty; fax records if you have them.

Mechanism (optional)

Main concerns (choose any)

Urgency

Sent over an encrypted connection and stored in our clinic system, never e-mailed.

For referring offices

Questions we hear from clinics

No. Physiotherapists in Ontario are primary healthcare providers, so patients can book directly. A referral still helps: some extended health plans require one for reimbursement, auto insurers usually want a physician's note, and your referral tells us what you want us to focus on. We contact the patient either way.

We call your patient within one business day of receiving the referral. Most new patients are assessed within the same week. Mark a referral urgent and we triage it the same day.

We bill most extended health plans directly. Concussions from a motor vehicle collision are billed to the auto insurer under the Statutory Accident Benefits Schedule, and we prepare the treatment plan. Other payers, or patients without coverage, can call us for self-pay rates. Your office never handles billing.

Fax them to 289-203-3071 with the patient's name and, if you referred online, the reference number from your confirmation. The patient can also bring copies to the first visit.

With the patient's consent, a one-page assessment summary is faxed to your office after the first visit, and a discharge summary when care ends. Add your fax number to the form so it reaches the right machine.

Stephanie Aubin and Juhi Israni, registered physiotherapists with advanced training in concussion management and vestibular rehabilitation. The clinic is a program of OMNI Health and Rehab at 960 Cumberland Ave, Burlington, ON L7N 3J6.

A 45 to 60 minute assessment: symptom history and screening, vestibular and oculomotor testing, balance, cervical spine examination, and graded exertion where appropriate. The patient leaves with an active recovery plan, and you receive the summary.

Patient asking whether they need a referral? Point them here.