Geriatric Assessment and Intervention Network
Referrals to the GAIN Clinic
It is ideal if referrals to GAIN are completed by a Physician or Nurse Practitioner (MD/NP) and completed through OCEAN following the link below. Self-referrals are also accepted and can be accessed and completed through the Self referral form link below.
Please copy and paste the link below to access the referral form.
If you are unable to complete an electronic referral, completed paper referral forms (which can be downloaded at the bottom of this page) can be faxed directly to the Haliburton Highlands GAIN office at 705-286-0720.
Haliburton Highlands 12893
Clinician form: https://ocean.cognisantmd.com/eRequest/2ef7eae5-a2a7-49de-8a2f-52f8c684f4f4
Self referral form: https://ocean.cognisantmd.com/eRequest/70a5a482-f216-4eb0-b600-9280750d104b
Please ensure the following items are either readily available for the home visit or brought to the clinic:
