Referral Form

If you're a family physician, NP, or specialist who would like to refer a patient to the Cognitive Behavioural Therapy (CBT) for Vasomotor Symptoms (VMS) of Menopause virtual group psychotherapy, please download the PDF referral form linked below.

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Please fax completed referral forms to 250-412-6457.
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Please ensure all referral forms include an active email address for the patient, as group registration information will be sent via email.