Maternal, Newborn and Paediatric Care Referral Forms

Paediatric Ambulatory Clinics

  • Paediatric Ambulatory Clinic Referral — online/ PDF
  • Adolescent Clinic — online
  • Paediatric Constipation Clinic Referral — online/ PDF
  • Paediatric Dermatology Clinic Referral — online/ PDF
  • Paediatric Gastroenterology Referral — online/ PDF
  • Paediatric Gynaecology Clinic Referral —  online/ PDF
  • Paediatric Neurology Clinic Referral — online/ PDF
  • Paediatric Respirology/Asthma Clinic Referral — online/ PDF
  • Paediatric Rheumatology Clinic Referral — online/ PDF

Multidisciplinary Subspecialty Clinics 

  • Child and Adolescent Eating Disorders Program Referral Form — online
  • Paediatric Diabetes Education Program —  online
  • Mother and Baby Follow-Up Clinic — online
  • Neonatal Follow-Up Clinic Referral Form — PDF
  • Antenatal Consultation Referral Form — PDF
  • Paediatric Complex Care Clinic (All referrals to the Complex Care Program are triaged at the Hospital for Sick Children. Please submit the referral through eCHN/EPIC)

Link to a description of all our services