Referral to
The Methadone Clinic,106NewcastleBlvd,Miramichi,NB,E1V2L7,622-7000,
fax622-8323
Date: ________________
Patient: ______________________________________________
Birth date: ____________________________________________
Medicare number: ______________________________________
Medicare expiry date: ____________________________________
Dear New Beginnings Clinic physician:
Please see the above-named patient who has an addiction to the following:
He/she is interested in commencing Methadone Maintenance Therapy for their
addiction(s). He/she is registered for admission to the Miramichi Addictions Recovery
Clinic.
Yours truly,
_________________________________________
New Beginnings Clinic 488 King George Hwy, Suite 2, Miramichi, NB, E1V 1M4