Referring Providers

Submit a referral

We make the referral process straightforward. Submit the form below and our intake team will follow up within one business day to coordinate care for your patient or client.

Step 1

Submit this form

Provide your details and your client's preferred contact information. No PHI required at this stage.

Step 2

We reach out

Our intake team contacts your client within one business day and coordinates their first appointment.

Step 3

We notify you

You receive confirmation once your client is booked, or notification if we are unable to reach them after three attempts.

WSIB MHPOC referrals are processed through WSIB and do not require this form. For VAC referrals, please complete this form and select Veterans Affairs Canada as the funding program below.
Prefer to fax? Send referral documentation to (705) 482-7763. A member of our team will follow up within one business day.
Privacy notice: This form collects referring provider information only. Client health information is collected through a separate secure, PHIPA-compliant intake process after your referral is received. No PHI is submitted or stored through this form.
REFERRING PROVIDER INFORMATION
Referral Details
General Reason for Referral (no PHI)
Client Contact Information
Client contact details are used only to coordinate intake. Full clinical information will be collected by our team through a PHIPA-compliant channel after this referral is received.
By submitting this form you agree to Serebro Health's Privacy Policy. This form does not constitute a clinical intake or guarantee of service availability.

Referral received

Thank you for your referral. Our intake team will contact your client within one business day to coordinate their first appointment. If you selected email or phone follow-up, you will receive confirmation once your client is booked.

If you have any urgent concerns please contact us directly at hello@serebrohealth.ca or 1 (888) 279-4322.
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