Users’ (Patients’) Committee

Help a child. Donate.

Book your first appointment

"*" indicates required fields

Name of doctor who referred you

Department you are being referred to (if known)

Attach a referral*

Accepted file types: jpg, png, pdf, doc, jpeg, Max. file size: 5 MB.

IMPORTANT: Ensure your file is under 5MB before uploading to avoid errors or rejection. If it exceeds the limit, compress or reduce its resolution. Please make sure that your attachment is clear and legible. We do not process incomplete applications or provide appointments without a copy of the referral. If you do not attach your referral, you will need to fax it to the department directly. Wait times depend on the priority assigned to the referral and can be as long as several months.

Patient Information

Child's last name*

Child's first name*

Date of birth*

MCH Medical record number (if known)

Health insurance card number*

Health insurance card expiration date*

'DD' corresponds to the child's date of birth.

Address*

Select your province or territory*

City*

Postal code*

Contact Information (for parent or guardian)

Your first name*

Your last name*

Your relationship to patient*

Email address

Phone number*

Alternate phone number

Comments

CAPTCHA

The Users’ (Patients’) Committee of the McGill University Health Centre (MUHC) is legally mandated to defend the rights of patients and works towards improving the quality of care and services.

Code of ethics

The Montreal Children’s Hospital, as part of the McGill University Health Centre (MUHC), is guided by the Code of Ethics. The Code of Ethics reflects the values and beliefs of the hospital and its staff, and covers the guiding principals of mutual respect, privacy, promoting open communication, preserving confidentiality and access to health information, informed care and treatment decision making, access to health information, and providing care in a compassionate and responsible manner.

Find out more about the Users’ (Patients’) Committee

This page needs an update? Report it here!