Referral - Ajax Harwood Clinic

⚠ This program may not be the right fit for:

Patients primarily seeking pharmacological management — Dr. Yu is not a psychiatrist and this program is not medication-focused
Patients involved in active legal or insurance disputes where clinical documentation may be used as evidence
Patients requiring individual one-on-one psychotherapy as the primary modality — this is a group-based program
Patients expecting a psychiatric assessment or formal diagnosis

✓ Well suited for patients with:

Anxiety, stress, emotional dysregulation, sleep difficulties
Depression (mild to moderate), PTSD, OCD, ADHD, psychosomatic conditions
Interest in awareness-based, non-pharmacological approaches
Willingness to attend group sessions and engage with experiential practice
Patients who are already rostered at Ajax Harwood Clinic, or who are open to transferring care

Program Details

What the Referral Involves

Format

Group-Based

Initial individual consultation with Dr. Yu, followed by group Presence Therapy sessions. Not a 1-on-1 ongoing therapy program.

Sessions

15-Session Block

Mon–Fri 9:30 AM · Mon–Wed 4:00 PM · Wed 4:00 PM (recommended entry) · Sat 11:30 AM (recommended entry)

Billing

Fully OHIP Covered

Group counselling under FHO has no impact on outside-use billing. No extra cost to patient or referring physician.

Location

Ajax & Online

In-person at 88 Harwood Avenue South, Ajax. Thursday noon SSA sessions available online via Zoom.

Response Time

Within 5 Business Days

We will contact the patient directly to schedule an intake consultation after receiving your referral.

Referred To

Dr. Carlos Yu

MD, CCFP(EM), FCFP, CTH · Assistant Professor, Queen's University · Ajax Harwood Clinic

How to Refer

Three Ways to Submit

📠

Fax

Download and complete the referral form below, then fax to:

905-683-1431

✉

Send completed referral form to:

ajaxharwoodclinic@gmail.com

Please do not include sensitive clinical information in unencrypted email.

📋

Online Form

Complete the short referral form below. We will follow up with you and the patient within 5 business days.

📄 Presence Therapy Referral Form

Download, complete, and fax or email to the clinic. The patient may also bring it to their first session.

Download Referral Form (PDF) →

Online Referral Form

For physicians who prefer to submit digitally. All fields are transmitted securely.

Referring Physician

Physician Name *

Billing Number

Phone

Fax

Email (for confirmation)

Patient Information

Patient Name *

Date of Birth

Patient Phone

Health Card (OHIP)

Referral Details

Urgency

Reason for Referral *

Referring a Patient to
Presence Therapy

📄 Presence Therapy Referral Form

Online Referral Form

The Eight Doorways In

Referring a Patient toPresence Therapy

📄 Presence Therapy Referral Form

Online Referral Form

The Eight Doorways In

Referring a Patient to
Presence Therapy