CMAP Health is OPEN and committed to offering uninterrupted, secure services through remote audio/ video platforms as well as in-person at our offices.

Call, e-mail or book with a therapist directly online from our website.

Contact Us for Help
118 Ochterloney Street, Dartmouth, Nova Scotia B2Y 1C7 (FREE PARKING AVAILABLE AT OTTAWA LOCATION)

Psychotherapy Referral Form For Physicians

SECTION A: REFERRER DETAILS
SECTION B: PATIENT INFORMATION
SECTION C: CLINICAL DETAILS
Please include all previous patient investigations for mental health treatment such as psychological tests and lab tests relevant for assessment.
IF POSSIBLE, PLEASE INCLUDE ALL PREVIOUS PSYCHIATRY/PSYCHOLOGICAL ASSESSMENTS