Facebook IconInstagram IconYouTube IconLinkedin Icon

Referral Forms

Mental Health Intake Form (Fillable online form sent electronically to intake worker)
Mental Health Intake Form (print, complete, mail in or drop off)
Mental Health Service Agreement, Informed Consent & Authorization
MINT Patient Information Form (to be completed by Patient and submitted with Physician Referral)
MINT Physician Referral Form
Rapids Health Referral Form
Rapids Family Health Team Logo White
The Rapids Family Health Team is a non-profit organization proudly funded by Ontario Health and the Ontario Ministry of Health and Long-Term Care. We partner with the province to deliver high-quality, compassionate, and collaborative primary care to our community.
Ontario Health Logo
Contact Us
Pontiac Drive (Main Site)
1150 Pontiac Drive, Suite 4,
Sarnia, Ontario
Tel. 519-339-8949
Access to Care Centre
481 London Rd. (Inside London Road Diagnostic Centre, 1st floor),
Sarnia, Ontario
Tel. 519-491-6188
Sarnia Physician FHO Group
After Hours Care
481 London Road (1st floor beside pharmacy), Sarnia, Ontario
Tel. 519-491-6188