Hamilton Health Sciences
Michael G. DeGroote Pain Clinic

Referral Forms

OHIP Referral Form - for Medical Management, Interventional Procedures, and 8-Day Interdisciplinary Program.  A referral is required by a physician. 

Pelvic Pain Program Referral Form  - A referral from your gynecologist, urologist or pain physician is required.

Intensive Program Referral Form  - this Program is not covered by OHIP.  Referrals accepted from Physicians, Veteran Affairs, WSIB, Insurance Companies, Employers, Lawyers, Communiity Rehabilitation Health Professionals, etc.


Hamilton Health Sciences • Hamilton, Ontario • 905.521.2100

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