Referral guide for clinicians
A one-page summary of who the clinic sees, what it does not accept, what to include and how to refer. Print it, or save it as a PDF for your EMR.
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Canadian Paediatric Bowel & Bladder Clinic
Referral guide for physicians and nurse practitioners in Ontario
Updated September 26, 2026. bbdclinic.ca/referral-guide
Who the clinic sees
Children aged 2 and older in Ontario with functional bowel and bladder problems. The first visit is by video, and the family receives a written plan. An in-person assessment is arranged when the physician decides it is needed, and a consultation note goes back to the referrer.
Accepted routinely
- Functional constipation
- Encopresis
- Primary nocturnal enuresis
- Daytime urgency or frequency
- Infrequent voiding
- Suspected dysfunctional voiding without red flags
Accepted after physician review
- Secondary enuresis
- Daytime symptoms plus bedwetting
- Recurrent afebrile UTIs
- Multiple failed prior treatments
- Significant ADHD, anxiety, autism or developmental complexity
- Prior urology or GI involvement
Not accepted: please refer elsewhere
- Child under 2 unless specifically accepted
- Suspected non-functional constipation
- Delayed meconium history
- Poor growth or malnutrition concern
- Persistent blood in stool without fissure
- Severe abdominal distension
- Bilious vomiting
- Suspected neurologic abnormality
- Urinary retention
- Recurrent febrile UTIs
- Known complex urologic anomaly
- Suspected abuse or safeguarding concern
- Medically unstable child
Refer these to general paediatrics, paediatric gastroenterology, urology or nephrology, or to an emergency department when acute.
Children under 2 are not seen routinely; explain the reason in the referral and the physician decides.
What to include
- Child's full name, date of birth, sex, and Ontario health card number with version code.
- Parent or guardian name, relationship, email address and phone number.
- Reason for referral and duration of symptoms.
- Relevant history, current medications, treatments already tried and how the child responded.
- Other providers involved (for example urology, gastroenterology, pelvic floor physiotherapy).
- Your name, role, clinic, billing number, and a fax number or email address for the consultation note.
- Any relevant results (growth, urinalysis, imaging) as attachments.
How to refer
Referrals open in January 2027. Please do not send referrals before then.
- Ocean eReferral: the listing will be published on the Refer page before referrals open.
- Fax: the number will be published on the Refer page once the line is active.
- Online referral form: bbdclinic.ca/refer
What to expect
- Acknowledgement to the referrer within 2 business days.
- A decision (accepted, more information requested, or declined with a suggested pathway) and, when accepted, a booking confirmation within 14 days.
- A consultation note faxed or emailed to you after the visit, and to any other provider you name.
- If the family cannot be reached or declines booking, the referral is returned to you with a note.
The clinic is not an emergency service. Send a child who is acutely unwell to an emergency department.
Next steps
Referring a child?
The clinic starts accepting referrals in January 2027. The criteria are published now.
A parent or guardian?
Families cannot refer themselves. Your child's doctor or nurse practitioner decides whether a referral to the clinic is right.