Health Care Providers


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If you have a patient that has been diagnosed with a life limiting illness and would like to link the patient with palliative care services in the Toronto Central LHIN area, a referral can be made by completing the Palliative Care Common Referral Form (CRF) along with the Toronto Central LHIN’s  Medical Referral From (MRF) and fax them to the Toronto Central LHIN (Home & Community Program) at 416-506-0374. These forms and information about the forms is provided below.

For questions or consultation concerning palliative services, please call the Toronto Central LHIN at 416-217-3822 (Mon - Fri) or 416-506-9888 (weekends or after hours).

Toronto Central Palliative Care Common Referral Form - The common referral form (CFR) is a multi-use form for referral to the CCAC, Palliative Physician Team, Palliative Care Unit/Residential Hospice and Visiting/Community Hospices across the TC LHIN. The form should be completed and faxed to the agency intended to receive the referral.

For additional information on the Palliative Care Common Referral Form, please see these Frequently Asked Questions.

Medical Referral Form - This form is to be completed by a  physician when referring to LHIN (formerly CCAC) services and should be submitted with the CRF.


Toronto Central LHIN Palliative Care Program
The Palliative Care Program supports clients by providing palliative, end-of-life services so they can die at home if they choose, or remain at home for as long as possible. The Toronto Central LHIN – Home and Community Division provides services to clients with a terminal disease with documented life expectancy of 12 months or less.

Referrals to the Palliative Program can be made from internal or external sources using the Palliative Common Referral Form (CRF) (see link above).