COMMUNITY REFERRALS
Community Referral by Fax
Download and complete the Bloom Path Community Referral Form, then fax the completed form to our team.
A Bloom Path Care Specialist will review the referral and follow up regarding the appropriate next steps.
Preview the Referral Form
Printable PDF • Complete by hand or electronically
Send Your Completed Referral
Fax: +1 (905) 248-3715
Once completed, fax the referral form to Bloom Path using the number above.
Supporting documents may also be faxed with the completed referral form. Please include the referring organization's name and contact information so Bloom Path can match the documents with the appropriate referral.
Download
Download or print the Bloom Path Community Referral Form.
Complete
Complete the referral form with the information needed for Bloom Path to assist with the referral.
Fax
Fax the completed referral form and any supporting documents to +1 (905) 248-3715.
Prefer to Submit Online?
You can also complete and submit a Bloom Path Community Referral online.
Submit Referral Online