Use this form to refer a patient or client for psychological assessment, therapy, or med-legal assessment. Our intake coordinator responds within one business day to confirm scheduling and next steps.
Family physicians | Specialists & physiatrists | Insurance adjusters
Response within 1 business day
Direct insurer billing for MVA & WSIB
Virtual assessments province-wide
(416) 485-5555
1
Your details
2
Patient details
3
Referral type
4
Clinical notes
Your details
Tell us about yourself and your practice so we can reach you to confirm the referral and provide updates.
I AM REFERRING AS A *
🛡 Physician / GP
OT / Physiotherapist
Other
🛡 Specialist / Physiatrist
📋 Lawyer / Legal
🛡 Insurance adjuster
Step 1 of 4
Patient details
Basic information about the patient or client you are referring. All information is held in strict confidence and transmitted securely in accordance with PHIPA.
ASSESSMENT / SESSION PREFERENCE *
In-person — Toronto clinic
Virtual — anywhere in Ontario
Either — no preference
PATIENT CONSENT
By completing this referral form, you confirm that:
(a) The patient / client named above has consented to this referral and to McDowall Integrative Psychology & Healthcare contacting them to arrange an appointment.
(b) You have obtained or will obtain appropriate consent for the sharing of clinical information in this form, in accordance with PHIPA (Personal Health Information Protection Act, 2004).
(c) You understand that McDowall will contact the patient directly to schedule an intake appointment. A copy of this referral confirmation will be sent to your nominated email address.
Step 2 of 4
Referral type & coverage
Select the assessment or service type you are referring for. If unsure, contact our assessment coordinator who will confirm the appropriate assessment type.
Comprehensive ADHD assessment for children, teens, or adults — schools, OSAP, and employer documentation
PSYCHOLOGICAL
Psychological / diagnostic assessment
Comprehensive psychological evaluation for diagnostic, clinical, or legal purposes
THERAPY REFERRAL
Individual therapy
Referral for individual therapy — anxiety, depression, trauma, PTSD, adjustment, or other presentations
URGENCY
PRIORITY LEVEL
Routine
Priority — within 2 weeks
Urgent — within days
Step 3 of 4
Clinical notes & submission
Provide any relevant clinical information to help our psychologists prepare for the assessment. All information is held confidentially under PHIPA.
SPECIFIC REQUESTS
REPORT RECIPIENTS (in addition to referring partner)
SUPPORTING DOCUMENTS
UPLOAD REFERRAL LETTER OR CLINICAL NOTES optional
↑ Drop files here or browse
PDF, DOC, or DOCX · Max 10 MB per file · PHIPA-compliant upload
Step 4 of 4
✓
Referral submitted!
Thank you for referring your patient to McDowall Integrative Psychology & Healthcare. Our intake coordinator will be in touch within 1 business day.
Response within 1 business day
Most patients scheduled within days of referral
Assessment dates confirmed by email & phone
Progress updates sent to referring partner
Rapid intake
Response within 1 business day
Most patients scheduled within days of referral
Assessment dates confirmed by email & phone
Progress updates to referring partner throughout
We accept referrals for
MVA · SABS psychological assessments
OCF-18 treatment plans
WSIB psychological assessments
LTD assessments
ADHD & psychoeducational assessments
Individual therapy
Prognosis & future care reports
Fitness for duty evaluations
Return-to-work assessments
Our reports are accepted by
All Ontario auto insurers
WSIB Ontario
All Ontario school boards & OSAP
Licence Appeal Tribunal (LAT)
Ontario Superior Court
PHIPA compliant: All referral
information is transmitted
and stored securely in
accordance with Ontario's
Personal Health Information
Protection Act, 2004.
