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Referral Form

Doctor's Desk

Download the fillable Referral Form and fax it to the clinic to begin the referral process.

Referral Forms (Fillable PDF): 

 

 

 

Clinic Fax Number: (905) 225-0130

Thank you for your interest in our clinic. At this time, there is a temporary suspension of new referrals until regular clinic operations resume. Thank you for your understanding.

 

Our website will be updated once regular clinic operations have resumed and new referrals can again be accepted.

General Neurology Referral Form (CURRENTLY NOT ACCEPTING)

300G Fourth Ave. Unit 202 (Second Floor)

St. Catharines, ON L2S 0E6

Copyright © 2025 Niagara Centre for Headache and General Neurology. All rights reserved. 

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