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​​​​​​​​​​​​​To submit a referral, download and complete the Diabetes, Exercise & Healthy Lifestyle Program Referral Form.

Once you have completed the form, fax it to 416 425 0301.

The form will be reviewed to ensure that it is complete; if incomplete, we will contact you to request the necessary information or reports.

Our office will call the patient with information about their first appointment.​

Checklist for a Complete Referral

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

  • Current 12-Lead ECG​
  • Most recent blood work containing lipids, A1C, blood glucose and microalbumin/creatinine ratio
  • If applicable: recent cardiac test results, including stress ECG, MUGA/echo, angiogram; clinic notes; cardiac consult notes

More Referral Links


Go to the Diabetes, Exercise & Healthy Living Program