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Epilepsy Diet Clinic - Referrals

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​Urgent Referral

If your patient needs immediate, urgent care, please do the following:

Contact Dr. Bercovici's office directly to request urgent care.

Dr. Eduard Bercovici

416 603 6452

You must make direct contact with Dr. Bercovici to complete an urgent referral.

Standard Referral

To complete the standard referral process, first download and complete the Epilepsy Diet Clinic referral form.

Once you have completed the referral form, fax it to Dr. Bercovici at the Epilepsy Diet Clinic 416 603 5768. The form will be reviewed to ensure that it is complete; if incomplete, the form will be returned to you.

Our office will call you with information about the patient's first appointment.

Your office is responsible for providing the patient with the appointment information, including time and location, and important documents, test results and imaging that they must bring.

It is extremely important to ensure that your patient brings the following [reports/tests/scans] as these will be required at their first appointment.

  • CD's of any imaging that was performed outside UHN
  • Detailed record on the food eaten over the last 3 days including quantity
  • Detailed record of your seizure types and numbers over the past few months

Checklist for a Complete Referral

In addition to the completed referral form, make sure to include:

  • Baseline blood work results
  • Baseline ECG
  • EEG
  • Previous Neurology consults / follow up
  • Brain Imaging

If this information is not included with the referral form, your referral may be returned as incomplete.​

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More Referral Links

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Go to the Epilepsy Diet Clinic