Referrals

Download and fill out our referral form to apply to DSPI’s services.

DSPI spine & pain referral form

Download Form

Regenerative therapies

Download Form

Ketamine referral form

Download Form

How to submit your form:

Simply email or fax your completed referral, along with supporting documents, to begin your journey with DSPI.

Have an appointment and need to fill out the intake questionnaire? Visit FAQ to download the form.

Email: info@dspi.ca Fax: 289-599-3774