Toronto Private Hospital Mental Health Online Referral

Referrer Information


If this referral is being completed by a registrar or intern, details of the referring consultant must be provided below

Patient Information

Funding source

Referral Information

rTMS information

Patients must be eigible to claim medicare for referral to be accepted


Details of medication trials conducted in the past year

Include food, drug and special needs including mobility or access issues
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If your patient is in acute crisis which presents a risk to the patient (i.e. is actively suicidal) or others, please contact your local Emergency Department.  Submission of an online referral does not does not automatically constitute acceptance of the referral. We will contact your patient, and you will be advised of the outcome.

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