Doctor Nurse Practitioner referral

Referring MDs & NPs

FHO/FHT/FHN: Referral to our program will not affect your access bonus

Our physician has a GP-Focused Practice designation and we only use the following billing codes:
  • A010
  • A917
  • K019
  • K020
  • K012
  • K024
  • K025

Tired of prescribing sleeping pills?

Or not sure what to do with fatigue patients?  Or, looking to expand the treatment arsenal of your chronic headache patients beyond just medication?  Behavioural, cognitive & lifestyle interventions are gold standard treatments for many medical issues.  Normally the cost of these therapies place them out of reach of most patients.  Our program brings down this barrier of accessing these therapies by making the medical assessments and therapies available under OHIP with a physician’s or nurse practitioner’s referral.

Make patients partner in their healthcare

Many patient become very passive in the face of chronic conditions like insomnia, chronic headache and fatigue.  They may come to only rely on their healthcare providers to fix their problems.  There is nothing more empowering for HCPs and patients than having access to Behavioural, cognitive & lifestyle interventions to treat these conditions.  Medications can still be helpful but they can be part of the treatment plan rather than being the entire treatment plan.  Many patients will no longer need medications in the management of these issues.

What to expect in terms of communication with your office

Our physician will send a consult letter usually after the second meeting with the patient.  During the first meeting (A010) their will be a history and then the patient will be given a self-monitoring diary to keep which will be reviewed at the follow-up appointment (A917).  At the time of this follow-up – and if appropriate – the patient will then either be invited to participate in the appropriate OHIP-funded Group Counselling Session (K019, K020, K012, K024, K025) for their issue and/or one-on-one therapy with an occupational therapist or psychotherapy, as per the patient’s preference.  If our physician believes that the patient is not appropriate for Group Counselling Sessions at this time, they will advise the patient of the same.  A summary of the assessment findings and our advice will be related to your office in the form of a consult letter.  After patients complete their therapy, they will have a final follow-up (A917) with the physician to review their results and may give further recommendations which will also be faxed to the referring HCPs.

How to refer to our program?

Fax your referral to the Institute for Behavioural & Functional Medicine along with your OHIP number.

Please include the patient’s Past Medical History and Medications they are taking and also medications that they have tried in the past.

Fax #: 647-660-9355

You may also download our referral form for printing or for uploading into your EMR.



Referral Form​


  • Click the Accuro Target in the bottom left corner
  • Then select Tools, Form Editor, & Publish/Download in the top left corner
  • Search the keyword “IBFM” (it will be two forms uploaded by user XXXXXX)
  • Select the IBFM REFERRAL FORM and press the download button in the bottom right corner, then hit the SAVE ICON (floppy disk icon) in the top right corner


Step 1

  • Go to the E-FORM Store at  and login / create an account; if you have an account, continue to the next step
  • Use the search feature on the bottom left and search IBFM in the above Eform Store
  • Under the action column on the right-hand side, download the ZIP FILE for the IBFM Referral Form
  • Click Save As and download to your Desktop

Step 2

  • In your Oscar EMR, select the ADMIN function
  • Then Select E-Forms and Manage E-Forms
  • Select IMPORT E-Form; then browse and select the ZIP IBFM Referral Form FILE from your desktop or where you saved it and then select IMPORT

Video Instructions

Telus PS Suite

  • Click “Help” from your main PSS Tab (same tab you would click patients records/appointments)
  • Click “Show Help”
  • Click “Configurable Content Library” from the Resource Corner
  • Click “Custom Forms Library”
  • Click “Ontario Forms”
  • Find the form you are looking for “IBFM Referral Form
  • Click “Download” beside the form you need
  • Save the file to your desktop
  • Go into your patient records
  • Click “Settings”
  • Click “Edit Custom Forms”
  • Click “File”
  • Click “Import Forms”
  • Double click the file you saved to your desktop
  • PSS will prompt you once the form has been successfully imported onto the system