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Get Mount Sinai Hospital C 195 2017-2024

6) 586-4800 x 4568 F (416) 586-8654 www.mountsinai.on.ca C 195 (Rev. 04.2017) Page 1 of 1 Date of Referral: (YYYY-MM-DD): Exclusion Criteria Includes Patients who: • are referred from hospital/clinics affiliated with departments of • are under the age of 18 psychiatry • have had a psychiatric assessment within the past 12 months • require 3rd party assessments (e.g. lawyer/court, child welfare • are currently followed by a psychiatrist services, WSIB, psycho-educational) Note: Pati.

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