Please select and complete the appropriate referral form below and click Send.  We strive to provide patients with an initial consult within 2-3 weeks of the referral being received.

Alternatively, physician offices can download a PDF version and fax directly to 905-471-7447 or email 

[contact-form-7 id="146" title="Physician Referral"]
[contact-form-7 id="147" title="Patient Self-Referral"]

I truly believe that it is because of the diligence exercised by Dr. Roumain and Dr. Dzineku that I have two beautiful babies today.