Canada health centre 2026

1. Click ‘Get Form’ to open the Canada Health Centre referral form in the editor.
2. Begin by entering the 'Date of Referral' in the format D/M/Y. Then, fill in the patient's last name, first name, and address details including city and postal code.
3. In the 'Patient Information' section, select the gender and enter the date of birth (D/M/Y). Include the OHIP number along with a contact phone number.
4. If applicable, provide information about any access requirements such as wheelchair needs or translation services. Attach a medication list if necessary.
5. Complete either Section A or Section B based on whether a biopsy has been completed. Fill in details regarding tumor size and suspected diagnosis as required.
6. In 'Referring Provider Information', include your billing number and indicate if you are the patient’s family physician. Provide additional physician information if needed.
7. Finally, review all entries for accuracy before signing. Once complete, fax your form to 705-739-5636.

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