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Referrals from Prescribers

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This form is to be filled out by healthcare professionals seeking addictions medicine for their patient. if you are not a prescriber, please have your client call the intake department at 1-800-263-2288 ext. 322.

Making a Referral?

Please download and complete our fillable Referral Form and fax it to 1-844-941-1983.

Addiction Services Central Ontario provides assessment, treatment and case management services to clients and their families aged 12 and older with substance use and gambling problems. Services may vary based on program mandates.