Referrals

To access our services & support, a referral from a family doctor, or other primary care provider, is usually required.

 Download the CPSE referral form (PDF) 

Catchment map:

Please include the following in your referral: 

1. Client information:
   Full name, address, telephone, birthdate, gender, marital status, health card number
   
   
2. Family member or friend able to attend the assessment:
   Name and telephone number
   
   
3. Family physician:
   Name, address, telephone, OHIP billing number
   
   
4. Reason for referral:
   Symptoms or behaviours, urgency, severity and frequency
   
   
5. Reason home visit is needed
   
   
6. Mental health:
   Cognitive status, prior psychiatric history, behavioural problems
   
   
7. Physical health:
   Acute and chronic conditions
   
   
8. Medications
   
   
9. Medical investigations:
   Results and tests ordered

Please direct all referral information to:

1. Phone: 416-480-4663
2. Fax: 416-480-5889
3. Email: cpse@sunnybrook.ca
4. Mail:
   Community Psychiatric Services for the Elderly,
   Room F307
   Sunnybrook Health Sciences Centre
   2075 Bayview Avenue
   Toronto, Ontario
   M4N 3M5