All referral forms on this website are also available as eForms for OSCAR, Avaros, Indivicare, and ACCURO EMRs. You can download some of the premade forms here from WorldEMR or fill the contact form below for any other eForms that are not listed for your EMR.

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LHSC & SJH Coordinated Mental Health & Addictions Intake – see info under Psychiatry & Mental Health
CMHA Thames Valley Addiction & Mental Health Services200 Queens Ave. Suite 260. London, ON
N6A 1J3
Phone: 519-673-3242 ext. 1281
Fax: 519-673-1022
Referral Form


Must be 12 years of age or older, and

Experiencing problematic opioid, alcohol, or substance use

Must reside in London-Middlesex, Elgin, or Oxford County
Clinic 217475 Talbot St
St Thomas, ON N5P 1C1
Phone: 519-631-9040
Fax: 519-631-9355
Email: [email protected]
RAAM Oxford County35 Metcalf Street, Woodstock, ON N4S 3E6Phone: 519-539-1111
Fax: 519-539-9111
Referral Form

Opioid Use – Oxford RAAM form

Alcohol Use – Oxford RAAM form

18 years of age or older AND struggling with alcohol or opioid use
Wharncliffe Addiction Clinic231 Wharncliffe Rd S
London, ON N6J 2L3
Phone: 519-963-0620
Fax: 519-963-0621
Accepts walk in plus physician referrals

Accepting new patients for opioid addictions treatment

Need eForms for your EMR system? EMR training? IT services? Online booking? Check-in kiosk? Contact us
Get all the London-area eForms for OSCAR, JUNO, Avaros, THT, Indivicare here
Contact [email protected] for any other eForm needs for OSCAR, JUNO, Avaros, THT, Indivicare, and Accuro EMRs.