The Wellness Fund

Referral Form

Illustration of two adults and a child playing in garden

Eligibility for Oona's Wellness Fund

Clients who are eligible will have to be referred to us by their primary care physician or midwife. In order to be eligible, the client must fall under a minimum of 3 of the following categories:

  • BIPOC (Black, Indigenous or Person of Colour)
  • Life changing medical diagnosis
  • Any form of disability
  • Developmental delay of birthing person or baby
  • Underhoused (homeless) or living in shelter system
  • Family income of $45k/yr or less
  • On Government Assistance
  • Refugee status
  • No immigration status
  • No family or outside support people
  • History of or current mental illness/mental health diagnosis
  • Victim or survivor of abuse/trauma
  • Child protection involvement
  • Substance use
  • No health benefits outside of OHIP
  • No OHIP

If you are a client who would like to seek our services through The Wellness Fund, please speak with your primary care physician or midwife and ask them for a referral. If you are a primary care provider, please complete the referral form below.

Referral Form

"*" indicates required fields

Referring Physician's Information

Referring Physician's Name*

Patient Information

Patient's Name*
MM slash DD slash YYYY


Please choose the location that is closest to you*


Must meet a minimum of 3 of the following eligibility (check all that apply)**


Check all that apply*

Services Required

Check all that apply*

Reason for Referral

This field is for validation purposes and should be left unchanged.

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