Refer to RAC LBP

Want to refer your patients to RAC-LBP (formerly ISAEC)?

To refer your patients to RAC-LBP:

You must be a primary care provider (Family Medicine Physician, Sports Medicine Physician or Nurse Practitioner in a family practice) in Ontario.
If you meet the above eligibility criteria, please proceed to completing the RAC-LBP Registration and Onboarding Module which includes referral criteria, an overview of the RAC-LBP Model of Care as well as the crucial role primary care plays in managing low back pain patients (approximately 5-10 mins).

Click here to access the onboarding module

The RAC-LBP program is a MOH initiative funded for primary care providers to improve low back pain management. Please note that only primary care providers can currently refer into this program.

If you have already registered with the program, the referral forms are available below.

If you have any questions, please email RAC Low Back Operations at RACLowBack.Operations@uhn.ca

Community Physiotherapists, Chiropractors or Physician Specialists

If you are a community Physiotherapist, Chiropractor or Physician Specialist with a patient who would benefit from further LBP assessment and management, please use this form to communicate with the patients’ primary care provider regarding registration and referral to the RAC-LBP program.

Community PT, DC and Physician Specialist - PCP Form
File Size:	1101 kb
File Type:	pdf

Download File

Regional Referral Forms

Erie St. Clair Region
(Windsor Regional Hospital)

Central Intake Contact Info:
T: 519-255-2269
F: 855-519-6611

ESC RAC-LBP Referral Form (Windsor Regional Hospital)
File Size:	684 kb
File Type:	pdf

Download File

Hamilton Niagara Haldimand Brant
(Hamilton Health Sciences)

Central Intake Contact Info:
T: 888-868-5568
F: 888-556-0966

HNHB RAC-LBP Referral Form (Hamilton Health Sciences)
File Size:	215 kb
File Type:	pdf

Download File

South West Region
(London Health Sciences Centre)

Central Intake Contact Info:
T: 519-685-8500 ext. 37873
F: 855-470-6584

SW RAC-LBP Referral Form (London Health Sciences)
File Size:	268 kb
File Type:	pdf

Download File

Alternatively, you can refer using your EMR:

For PSS Users
For Accuro User

Waterloo Wellington Region
(Grand River Hospital)

Central Intake Contact Info:
T: 519-947-1000 option 3
F: 844-237-5240

WW RAC-LBP Referral Form (Grand River Hospital)
File Size:	824 kb
File Type:	pdf

Download File

Alternatively, you can also refer using Ocean eReferral to the WW Orthopedic Central Intake by selecting Spine (ISAEC Low Back Pain Program) as the primary problem.
Please email ereferral@ehealthce.ca for more information about e-Referral.

Central Region
(Markham Stouffville Hospital)

Central Intake Contact Info:
T: 905-472-7019
F: 855-346-9138

Central RAC-LBP Referral Form (Markham Stouffville Hospital)
File Size:	668 kb
File Type:	pdf

Download File

Central West Region
(William Osler Health System)

Central Intake Contact Info:
T: 905-796-0040 ext. 7175
F: 905-796-4912

CW RAC-LBP Referral Form (William Osler Health System)
File Size:	743 kb
File Type:	pdf

Download File

Mississauga Halton Region
(Trillium Health Partners)

Central Intake Contact Info:
T: 905-338-2983 ext. 4912
F: 833-230-6623

MH RAC-LBP Referral Form (Trillium Health Partners)
File Size:	948 kb
File Type:	pdf

Download File

North Simcoe Muskoka Region
(Couchiching Family Health Team)

Central Intake Contact Info:
T: 705-735-0239 ext. 2
F: 705-792-3329

NSM RAC-LBP Referral Form (Couchiching Family Health Team)
File Size:	670 kb
File Type:	pdf

Download File

Toronto Central Region
(Toronto Western Hospital, St. Michael's Hospital, Sunnybrook Health Sciences Centre)

Central Intake Contact Info:
T: 416-967-8617
F: 877-411-4577

TC RAC-LBP Referral Form (Toronto Western Hospital, St. Michael's Hospital, Sunnybrook Health Sciences Centre)
File Size:	668 kb
File Type:	pdf

Download File

Central East Region
(Scarborough Health Network)

Central Intake Contact Info:
T: 800-263-3877 ext. 2828
F: 833-222-9065

CE RAC-LBP Referral Form (Scarborough Health Network)
File Size:	709 kb
File Type:	pdf

Download File

Champlain Region
(The Ottawa Hospital)

Central Intake Contact Info:
T: 613-798-5555 ext. 13827
F: N/A

Champlain Region- Online Referral Form
https://www.healthcareworks.ca/eforms/referrals/isaec/SitePages/Home.aspx

Please email info.isaec@toh.ca for more information.

South East Region
(Kingston Health Sciences Centre)

Central Intake Contact Info:
T: 613-544-3400 ext. 2382
F: 613-544-7453

SE RAC-LBP Referral Form (Kingston Health Sciences Centre)
File Size:	667 kb
File Type:	pdf

Download File

North East Region
(Health Sciences North)

Central Intake Contact Info:
T: 855-653-7966
F: 855-567-7969

NE RAC-LBP Referral Form (Health Sciences North)
File Size:	667 kb
File Type:	pdf

Download File

Alternatively, electronic referrals (through Ocean eReferral) can be sent directly to the NE MSK Central Intake from most EMRs. Simply select “Spine (RAC Low Back Program)” as the reason for referral.
Please contact Ontario Health North eServices deployment team to learn more.
wendy.smith@lhins.on.ca
mark.richards@lhins.on.ca

North West Region
(Thunder Bay Regional Health Centre)

Central Intake Contact Info:
T: 833-706-9417
F: 844-497-2445

NW RAC-LBP Referral Form (Thunder Bay Regional Health Centre)
File Size:	668 kb
File Type:	pdf

Download File