Referring Patients


Referral Forms

For those wishing to attend MBCPM™ Course, a physician’s or nurse practitioner’s referral is required for admission to this trauma-informed course.

NNC Referral Form.  Please check our Course Locations table to find a course accessible to your patient and corresponding fax number, or the website of the facilitator providing the course in your area to use their referral form.  Or use our generic referral form provided here. A checklist on the form is provided for checking eligibility in case a client or patient is not appropriate.

Some facilitators, such as non MDs in private practice, are not covered by the Provincial Health Plan and there may be a course fee in addition to a materials fee. Some facilitators may be covered by extended benefits plans.

For referral to alumni courses, a physician’s/nurse practitioner’s referral is only required if more than a year has passed since the last enrolment.

Information for Physicians

One-to-one consultations are usually not done by the facilitator, so please do not include patient history packages. A brief diagnosis on the application form is appreciated.

The Referral Process

It is important to establish a course is due to be offered at the location you have selected. Once the referral for entering a MBCPM™ basic course has been received, the prospective participant would likely be contacted by staff of the facilitator, usually near to the time a course is being offered.


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