Request for Services
The most efficient way to submit a request for services, is through our Online Referral/Request for Service Form. (Note: Ensure your browser is set to allow pop-ups.) A Reference Number will be provided upon completion.
ACCESS THE ONLINE REFERRAL / REQUEST FOR SERVICE FORMA request for service form can be submitted by an individual, family, substitute decision maker or any health care provider to determine if the person is eligible for service with the Extra-Mural Program. All requests for service will be managed through the care coordination center (CCC) if you do not hear from the CCC within 2 business days, please call 1-(844) 982-7367.
Alternative methods for submitting a referral / request for services form are:
Care Coordination Centre (CCC) will contact the patient within two workdays of your submission. If you do not hear from CCC within this timeframe, please call 1-844-982-7367.
If you have questions about EMP services or would like to request services a referral please contact the Care Coordination Centre at 1-844-982-7367.