International Patient Program
International Patient Program

International Patient Referral Form

All families of international patients who want treatment at SickKids for their child are required to complete an application form. The form must be completed in English and in full. There are two sections that need to be completed within the application, as follows:

  1. Sections A-F must be completed by the child's parents or legal guardian, including signatures
  2. Sections G-K must be completed by the child's doctor, and must include:
    • A complete medical history,
    • Current medical notes (completed within the last six months),
    • Copies of the child's recent laboratory and other test results, including imaging CDs,
    • A copy of the moving echocardiogram (ECHO) for review, if your child has a heart condition requiring possible treatment at SickKids

Please click here to access the required application form.

 

Please forward your completed application to the International Patient Program:

  • By email: international.patientprogram@sickkids.ca
    Please note that email may be intercepted between the sender and the receiver and is therefore neither secure nor confidential. Your continued use of email communication confirms that you accept this risk.
  • By fax: 1-416-813-8667
  • By Mail/Courier: International Patient Program 
    • The Hospital for Sick Children 
    • 555 University Avenue  
    • Toronto, Ontario, Canada  
    • M5G 1X8