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​​You can get all the referral information you need by calling 416 340 4018.

Standard Referral

To complete the standard referral process, please review and complete the following checklist:

Checklist for a Complete Referral

  1. Referral letter from Most Responsible Physician (MRP)
  2. Medical History –pertinent test results (i.e. CT scan; Small Bowel Follow Through; abdominal ultrasound; endoscopies; upper GI series)
  3. OR notes indicating length of small bowel remaining
  4. Lab work trend (past 1 week)
  5. Current PN prescription
  6. Current medication profile, include prn meds
  7. Dietitian's anthropometric assessment and nutrition care plan
  8. If central line inserted, radiology report confirming catheter tip position

Once you have completed all forms, fax them directly to Dr. J. Allard at 416 340 5455.

The forms will be reviewed to ensure that they are complete; if incomplete, the forms 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. ​

More Referral Links

Go to Home Parenteral Nutrition Support Clinic​