Referrals
If you are a healthcare provider seeking to make a referral, please download the following form and either fax or email the completed form to our office. Incomplete referral forms will not be processed, and referrals that do not clearly indicate the referring professionals name and contact information also will not be processed. Please complete each section of the form.
Important notes when making a referral:
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If the patient is a Nisga’a Citizen, please contact Nisga’a Valley Health at 250-633-2611 to make a referral, as Nisga’a Valley Health has their own referral form and process.
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If the patient is Status First Nations registered with First Nations Health Authority, please include their status number and/or their PHN number in the referral form.
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All other referrals are considered fee for service. Session are $150.00 per session and patients can submit their receipts to their extended benefits provider for re-imbursement. If the patient is RCMP or Veterans Affairs Canada, we direct bill both plans, and prior approval requests will be submitted by our office once the referral is made.
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If the patient does not have extended benefits, or any other forms of coverage, patients are responsible for the full fee.