Referral Forms

Community Form

To further support efficient transitions from hospital to community, the Toronto ABI Network  provides up-to-date information on operational changes, services offered, availability of in-person and/or virtual services, and changes to wait times in the following report:

Before completing the ABI community referral form, please take a moment to review the program comparison charts to determine whether your patient meets criteria.

ABI Community referral form

The ABI Community referral form must be completed when referring to a community-based ABI program (e.g., CHIRS, Cota, PACE, etc.)

To submit via fax:

Please complete the form and fax it to the Toronto ABI Network office at 416-597-7021.

Please use black ink when completing the referral form to ensure the form is legible, and include all relevant brain injury medical and consult reports. 

To submit via Ocean e-referral:

Please note: An Ocean account is required in order to use the e-referral form. Contact Toronto Region eServices Deployment Team at eServicesToronto@uhn.ca for information on how to join.

The neuro-oncology rehab programs will only accept referrals using the below neuro-oncology referral form.

Neuro-oncology outpatient rehabilitation referral form
(for neuro-oncology patients only)

Along with our partners, Toronto Rehab – UHN and Hennick Bridgepoint Hospital – Sinai Health, we are taking a coordinated approach to ensure appropriate timing to outpatient rehabilitation for these patients.  This Neuro-oncology Referral Form will help to better serve this patient group, ensuring rehab happens at an optimal time along their oncology journey.

For more information about neuro-oncology rehabilitation review the outpatient ABI rehab service information sheet.

To submit via fax:

Please complete the form and fax it to the Toronto ABI Network office at 416-597-7021.

*These forms are periodically modified. To make sure you are using the most current version, please download it from this webpage.