The form is used to refer a child/youth to tertiary medical consultation services at CPRI. This is a one-time developmental behavioural consultation with a CPRI paediatrician or a psychiatrist. It can also include diagnostic opinion/interdisciplinary ASD diagnostic assessment. Referrals will only be accepted from a medical specialist (e.g. paediatrician, psychiatrist, neurologist, geneticist). All CPRI recommendations are provided to the referring specialist.
Application may only be completed for recipients of ODSP.
The following approved health care professionals licensed to practice in Ontario can complete the application:
• Physicians, Nurse Practitioners, Registered Nurses, Occupational Therapists, Physiotherapists, Physician Assistants, and Psychologists*
*Psychologists can only complete the Medical Transportation section of the form.
The application may only be completed for medical supplies, items, and devices listed in the MSN Schedule of Benefits (
https://www.ontario.ca/page/ontario-disability-support-program-health-and-disability-benefits) and items must not be otherwise reimbursed or subject to reimbursement from any other source.
