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 

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