Mandatory Referrals


The General Regulation under the Naturopathy Act, 2007 includes a series of mandatory referral indicators.  That means when certain conditions exist, a Member must refer a patient to a Medical Doctor, a nurse practitioner registered in the extended class or a member of another regulated health profession for whom the applicable referral is within their scope of practice.  The situations that require a mandatory referral are when:
  • A patient’s life is or may be at risk (in such cases, a Member must call emergency services and transfer the patient to a hospital).
  • A patient’s condition prevents the Member from communicating a diagnosis because the condition is beyond the scope of practice of the profession.
  • Treatment of a patient’s condition is beyond the scope of practice of the profession.
  • Treatment of a patient’s condition requires diagnostic, monitoring or treatment related technology that is beyond the scope of practice of the profession.
  • The patient or their authorized representative asks the Member to refer the patient to another Member of the College of Naturopaths of Ontario, or to a member of another health profession.
  • A laboratory test result is a critical value test result, which means it shows a marked deviation from the reference ranges, with no clear indication to the laboratory that these are expected deviations.
  • The patient’s response to treatment is not adequate and unlikely to improve based on alternative treatments available from the Member, or the patient’s condition significantly deteriorates and is likely to continue to do so without a referral.

Supportive or Other Health Services after Referral



A Member who has been required to refer a patient is not prohibited from providing supportive or other health services, within the scope of practice of the profession, provided they collaborate with:
  • the person to whom the patient was referred, and
  • the patient.

More information about making and accepting referrals can be found in the Referrals and Consultations Guideline.