For Healthcare Professionals | Referral Process

Referral Process

Physician to Physician Referral Process-Psychiatric Consultation and Assessment

The Psychiatric Consultation service provides a one-time appointment with a psychiatrist for diagnostic clarification, medication review, and treatment recommendations through a shared care model with family physicians and pediatricians.

The referral form is to be used for ONE-TIME psychiatry consultation for children and youth from ages 2 to their 18th birthday.

This form is NOT to be used for urgent psychiatric consultation. If you are concerned about acute safety issues for your patient (e.g., suicidal ideation), please contact your local crisis service or direct your patient to the nearest Emergency Room.

To request psychiatric consultation services, please fill out ALL SECTIONS of the form and fax to 905-521-7938 to initiate your referral.

Please note that the form is NOT to be used for ongoing mental health services or treatment.  If such services are required, please call the agency for your area.  For a list of agencies by area click here.   Important Note: The family can self-refer to an agency while awaiting their psychiatric consultation.

Referral Process for Psychiatric Consultation:
• Referrals require physician/NPO support (including physician/NPO signature)
• All sections of the referral form must be completed by a physician/NPO and faxed to the CYMHP Central Referral office. The referral form can be found below or on the right side of the website.
• For the City of Hamilton, we are requesting that referring physicians/NPOs request consent to share their referral information with CONTACT Hamilton and/or Youth Wellness in an effort to coordinate care.
• Referral information is sorted and prioritized by the Central Referral team. We are not able to accept incomplete referrals and incomplete referrals will be returned. All fields must be completed.
• Families are contacted directly by Centralized Registration to schedule the appointment.

For more information on the Psychiatric Consultation Referral Flow Process, click here.

Psychiatrtic Consultation Form for City of Hamilton

Psychiatric Consultation Form for Niagara/Haldimand-Norfolk/Brant/Burlington


Emergent Referrals to the Inpatient Unit:

• The physician is to contact the Unit directly at 905 521-2100 ext. 72800.

• You will be asked to fax a psychiatric assessment and any other relevant documentation to 905 577-8499.

• The information is reviewed by the team and disposition communicated promptly to the referral source.


Referrals to Ambulatory Services, Inpatient and Day Hospital Services

Please go to the Referrals page for information on how to refer patients.

Associated Files

Psychiatric Consultation Request Form for Hamilton

Psychiatric Consultation Request Form for Hamilton  

Psychiatric Consultation Request Form - Outside Hamilton

Psychiatric Consultation Request Form - Outside Hamilton