Referral Form

At Mississauga Chronic Pain Centre, we pride ourselves on providing high quality, comprehensive, multi-modal pain management services to our patients, along with short wait-times as we realize the debilitating impact of chronic pain.

There is NO billing negation for FHO/FHN physicians.  Simply identify yourself as such on our Referral Form.

Please FAX the referrals to 647.347.9127.

REFERRAL FORM