How to Make a Referral

The Paediatric Pain Program is currently accepting referrals from physicians at LHSC, St. Joseph’s Health Care, Fowler-Kennedy Institute and Parkwood as well as the community. We will be expanding to accept referrals from other community physicians and centres in the near future.

Referral Criteria and Form

Referring physicians should review the referral criteria and complete the following referral form, making sure to include all requested documentation.

Prior to referring to the Paediatric Pain Program, medical investigations related to the pain problem should be completed and reviewed with families. Once you are being seen by our program, the focus will shift to managing/decreasing chronic pain and reducing the impact that it has on your life. Typically, it will not involve further medical testing (e.g. MRI’s, x-rays, CT scans, etc.). After a period of involvement with the Paediatric Pain Program, we will transition care back to the primary care team.

Paediatric Chronic Pain Program - Referral Criteria

Paediatric Chronic Pain Program - Referral Form

ChIPS - Referral Criteria

ChIPS - Referral Form