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International Patients
The International Patient Program (IPP) helps children living outside of Canada who require access to specialized paediatric care not available in the country or region where they reside. As the first point of contact for international inquiries and referrals to SickKids, IPP assists with over 1,000 inquiries and facilitates over 100 new patient referrals. IPP also supports temporary residents, such as visitors, international students and children/youth temporarily living in Ontario with a parent/legal guardian on a study or work permit.
What we do
Our International Patient Program team provides a coordinated approach for international patients to access the expertise available at SickKids. Your child will be assgined an International Case Coordinator. Our team will:
- Guide you with the medical records and other documents required for your referral to be processed;
- Communicate with you and your child's referring physician;
- Collaborate with SickKids physicians to develop a plan tailored to meet the care needs of your child;
- Provide cost estimate based on the plan recommended by the SickKids physician;
- Facilitate scheduling of appointments;
- Support entry into Canada as required;
- Provide information regarding travel and temporary stay in Canada when required;
- Guide you through the hospital upon arrival and arrange interpreter services;
- Ensure smooth discharge from SickKids and support transition back so that follow up care is done from your home country;
- Ask you for feedback on your experience at SickKids so we can continue to offer high quality service;
Our principles
All children deserve access to specialized health care, regardless of their place of origin or geographic location. However, many countries do not have the level of care available at SickKids due to economic circumstances or insufficient capacity to provide specialized treatment. While the priority at SickKids is meeting the needs of children in Ontario, we acknowledge that there is a moral responsibility to provide care to critically ill children from abroad. Based on key principles, our screening process allows SickKids to offer care to international children in need.
Age
Applicants up to 17 years of age may be considered, provided the proposed treatment is completed by their 18th birthday.
Priority
As a referral hospital in Ontario, SickKids' priority is the treatment of children in Ontario requiring emergent, urgent, and critical care.
Capacity
No child in Ontario will have treatment denied or deferred in favour of an international child. The IPP focuses on SickKids' clinical areas/programs with the internal capacity to accept international patients.
Cost Containment
SickKids will use technology along with the SickKids team's unique capabilities to provide cost-effective and efficient clinical care and expert advice for our international patients and families.
Eligibility
International patients must meet specific eligibility criteria for treatment service at SickKids based on regulatory guidelines set by the Ontario Ministry of Health and the Canadian Medical Protective Association (CMPA). All international patients must be approved by the Surgeon-in-Chief and/or the Paediatrician-in-Chief to ensure compliance.
Sustainability
All revenue from international patient activity will be directed back to the hospital to cover the cost of treatment and to support program development/capacity growth for Ontario patients. International patients are not eligible for funding through the Ontario Ministry of Health and require coverage in full prior to receiving treatment.
Definition of an international patient
At SickKids, an international patient is a:
- Non-Canadian citizen who is visiting or temporarily residing in Canada and will return to their country of origin, or
- Canadian citizen residing permanently abroad visiting Canada and will return to their country of permanent residence
Ineligible patients
SickKids cannot accept the following patients for medical and/or surgical treatment:
- Children over 18 years of age, or children who will not complete their treatment before 18 years of age.
- Children requiring emergent or urgent care;
- Children with highly complex multi-condition medical diagnoses who require long-term, ongoing care or rehabilitation; or
- Children with treatment available in their home country or region at a comparable level of care provided by SickKids.
Criteria for acceptance for medical and surgical treatment, and consultation at SickKids
- The child is under the age of 17, and treatment will be completed by their 18th birthday.
- The child has complex treatment/surgical needs.
- Treatment is not emergent or urgent.
- The required specialized treatment is not available in the child's home country or region.
- There is capacity within the requested SickKids program to accept an international patient, without negatively impacting access to the program for children from Ontario and Canada.
- There are medical services available in the child's home country to provide follow-up care once the child returns home.
Our services
SickKids is ranked the top paediatric health-care centre in the world, according to Newsweek's 2022 World's Best Hospitals list for facilities specializing in paediatrics. As Canada's most research-intensive hospital and the largest center dedicated to improving children's health in the country, SickKids offers support to international patients through the following three types of services:
Subspecialties and Divisions
SickKids has over 225 Paediatric Subspecialties across 25 divisions in Paediatric Medicine and Paediatric Surgery and 11 Centres of Excellence. There are over 70 specialized surgical procedures that can be offered by world renowned surgeons at SickKids.
Diagnosis and Recommendations
SickKids can offer a medical second opinion (MSO) to support international patients and physicians abroad with validating diagnosis and medical/surgical treatment recommendations. MSO involves review of medical records from abroad, such as physician consults, lab results, pathology results, diagnostic imaging. Pathology analysis of specimens and radiology review may also be provided.
Virtual Consultations and Follow Ups
Virtual care can include medical/surgical consultation, pre-screening patients before their travel to SickKids for treatment, follow-up appointments after treatment at SickKids. This consultation may include review and consultation on complex, rare cases or cases that have failed the first course of treatment. It may also include referring physician or medical team abroad if required. Through a virtual appointment with our medical and surgical specialists, you can access care without coming to the hospital. Following the appointment, a medical note will be sent to the referring physician abroad.
Specialized surgical expertise
More than 70 areas of specialized procedures are offered within the surgical areas of Perioperative Services, showing the depth of our unique skills.
Surgical Correction
- Valve sparing surgical repair and RVOT stenting for tetralogy of Fallot
- Sutureless repair for pulmonary vein stenosis (PVS)
- Double-switch procedures for congenitally corrected transposition (ccTGA)
- Unifocalisation of MAPCA in complex pulmonary atresia
- Primary repair of multiple VSDs
Minimally Invasive Cardiac Surgery
- Axillary approach for Atrial Septal Defects, Partial AVSD and Valve Repair
- Thorascopic sympathectomy for ventricular arrhythmia
Mechanical Circulatory Support
- All intra-corporeal and para-corporeal systems
Hybrid Procedures
- Norwood for borderline left ventricle (LV)
- Device closure of ventricular septal defects (VSDs)
We are especially well positioned to address Tetralogy of Fallot and Transposition of the Great Vessels. For more information, please visit the program Cardiovascular Surgery.
Oral Anomalies
- Oral rehabilitation of congenital enamel or dentin anomalies
- Endosseous implant restoration for oral clefts and craniofacial conditions
- Craniofacial orthodontic correction
- Surgical management of jaw cysts and tumours
- Correction of acquired or developmental dentofacial deformities
Dental Caries
- Comprehensive oral rehabilitation of severe early childhood dental caries
- Management of medically complex children with dental disease
Dental Trauma
- Acute surgical management of dental traumatic injuries
Our strength is providing expert planning and set up for orthognathic and craniofacial surgery as well as dental care for children with complex medical conditions. For more information, please visit the program Dentistry
Esophagus
- Surgical management of esophageal atresia
- Surgical management of tracheo-esophageal fistulae
Anorectal Anomalies, Hernia
- Surgical management of anorectal anomalies including Hirschprung’s disease
- Surgical management of congenital diaphragmatic hernias
GI and Hepobiliary Disorders
- Surgical management of complex gastrointestinal disorders
- Surgical management of complex hepatobiliary disorders
Thorax and Abnormal Conditions
- Surgical management of thoracic, pulmonary and abdominal anomalies and tumors
- Correction of pectus anomalies and breast lesions
- Minimally invasive surgery
We have world class expertise in esophageal atresia and tracheo-esophageal fistula repair. For more information, please visit the program General and Thoracic Surgery
Brain and Spinal Tumors
- Evaluation and surgical management of brain and spinal tumors
- Evaluation and surgical management of rare malignant paediatric embryonal brain tumors
Epilepsy, Movement and Neurophysiological Disorders
- Surgical management of complex epilepsy, including lobectomy and hemispherectomy
- Evaluation and surgical management of movement disorders, including dystonia and spasticity
- Dorsal rhizotomy for complex neurophysiological disorders
Vascular Conditions of the Brain and Spinal Cord
- Surgical and endovascular management of arteriovenous malformations and pediatric cerebral aneurysms
- Surgical revascularization for Moyamoya disease
- Surgical management of Vein of Galen malformations
We provide state of the art and innovative care in managing paediatric embryonal brain tumours and complex epilepsy. For more information, please visit the program Neurosurgery
Corneal Reinnervation, Strabismus, Eyelid, Oculplastic
- Surgical management of corneal reinnervation surgery
- Surgical correction of strabismus
- Oculoplastic surgery and reconstruction of the eyelids
Retina
- Surgical management of Retinoblastoma
- Surgical management of complex retinal and vitreo-retinal conditions
Keratoconus, Cornea, Glaucoma
- Surgical management of Keratoconus
- Surgical management of corneal reconstruction including corneal cross-linking and corneal transplant
- Surgical management of Glaucoma
We have developed new innovative approaches to corneal anaesthesia and to the management of retinoblastoma. For more information, please visit the program Ophthalmology & Vision Sciences
Scoliosis and Spinal Deformities
- Re-alignment of spinal deformities
Lower Extremity and Cerebral Palsy
- Surgical correction of lower extremity deformities including hip, alignment, leg length discrepancy, foot & ankle
- Surgical treatment of cerebral palsy and neuromuscular disease
Bone Cancers and Metabolic Conditions
- Excision of pediatric bone and soft tissue cancers and surgical reconstruction
- Treatment of congenital, genetic / metabolic skeletal conditions, including skeletal dysplasia & osteogenesis imperfecta
Our world class expertise is in the management of complex spine deformities and in the management of boney and soft tissue sarcomas. For more information, please visit the program Orthopaedic Surgery
Cochlear Implant, Hearing Aid
- Cochlear implant and bone anchored hearing aid surgery
Otologic Surgery, Airway
- Endoscopic otologic surgery including cholesteatoma surgery
- Evaluation & surgical management of complex airway disorders including laryngotracheal birth defects & injuries
Voice Disorders, Sinus and Central Skull
- Evaluation and surgical management of voice disorders including recurrent respiratory papillomatosis
- Endoscopic sinus and central skull base surgery
Head and Neck
- Surgical excision of tumors of the head and neck
Our strengths include cochlear implant surgery and endoscopic otologic and sinus surgery. For more information, please visit the program Otolaryngology
Facial Paralysis, Corneal Reinnervation
- Facial paralysis reconstruction
- Corneal reinnervation surgery
Injuries of the Brachial Plexus, Spinal Cord
- Surgical reconstruction of obstetrical brachial plexus injuries
- Nerve transfer surgery for spinal cord injuries
Craniofacial Conditions, Facial Clefts, Ear Injuries and Anomalies
- Surgical management of complex craniofacial conditions including encephalocoele
- Surgical correction of congenital facial clefts
- Surgical reconstruction of ear anomalies (Microtia) and traumatic ear injuries
Hand, Limb and Burn Injuries
- Reconstructive surgery following burn injuries
- Reconstructive surgery for complex anomalies and injuries of the hand and extremities
We have world class programs in facial paralysis reconstruction and obstetrical brachial plexus reconstruction. For more information, please visit the program Plastic & Reconstructive Surgery
Hypospadias, Bladder
- Primary and revisionary surgery for hypospadias
- Surgical correction of renal and bladder anomalies, including bladder exstrophy
Incontinence, Kidney and Urinary Tract
- Surgical management of neuro incontinence with restoration of bowel and bladder control
- Surgical management of tumors of the kidney and urinary tract
- Surgical management of complex kidney stones
Kidney Transplant
- Living related kidney transplantation
Our team has particular expertise in both primary and revisionary hypospadias surgery, bladder exstrophy and the correction of neuro incontinence. For more information, please visit the program Urology
International patients who meet the eligibility criteria may be referred for care at SickKids.
- For surgical care, medical treatment or consultation, please download the IPP Referral Form (PDF).
- For a Medical Second Opinion (MSO), please download the MSO Referral Form (PDF).
Please ensure:
- For IPP Referral Form, the parent/legal guardian should complete and sign sections 1–7. The referring physician should complete and sign sections 8–11.
- For MSO Referral Form, parent/legal guardian should complete sections 1–3, and 6. The referring physician should complete and sign sections 4–5.
- All applications should include the following documents:
- A complete medical history and current condition;
- Medical notes (completed within the last 6 months);
- Recent laboratory, test results, and imaging studies (X-rays, CTs, MRIs, etc.) must be sent in DICOM format by either uploading to a secure file transfer link provided by IPP, or by courier on CD or USB drive;
- If pathology analysis is required for the physician to provide an opinion, digital images of the pathology slides should be sent. If your referring physician does not offer scanned slides, all original pathology slides and report, as well as a block or 10 unstained slides from a representative block must be sent by courier;
All information must be submitted in English, translated by a medical translator and include patient's name and date of birth (DOB). Referrals with documents in another language will not be reviewed by the SickKids team. Please send the referral to the International Patient Program.
Once we have received the completed referral form and all relevant medical information, your child's application will be reviewed by the appropriate SickKids medical experts. During this process, the medical team may ask you/your child's doctor to provide additional information to determine your child's eligibility. All requested information must be received in order to proceed.
If SickKids can provide the services requested, the referral will be accepted. Our team will send you the intake package, including a letter with the proposed treatment plan, cost estimate, and information about the next steps that are required before the referral is accepted.
If SickKids is unable to provide the services requested, the referral will be declined. When possible, we will provide a list of alternative paediatric centres and/or consultant doctors closer to your child's residence that may be available to provide the services requested.
SickKids requires full financial coverage of the services before any service can be scheduled. You can arrange direct payment in full by cheque, bank transfer, or online via credit card. Your insurance company, embassy, or government can also provide financial coverage for the full amount of the proposed services via a Letter of Guarantee.
Please note: In the event that there are unexpected complications and/or additional medically necessary care is required while your child is at SickKids, there will be additional costs which will be provided in the final invoice. Medically necessary care will be communicated to your insurance provider, or foreign government/embassy, with a request for guarantee of payment.
If you are requesting humanitarian financial support for your child through the SickKids Herbie Fund, additional financial review and approval from the Herbie Medical Review Committee will be required.
Upon receiving financial coverage, we will send you a notification of acceptance. The case coordinator will work with you to book the appointments.
If your child is coming for medical or surgical treatment, we will provide appointment dates, times and locations, in addition to other important information in preparation for you and your child's travel. Your International Case Coordinator will also arrange to meet with you prior to your child's first medical appointment at SickKids.
For virtual care, you will need internet access, and a computer or smartphone that has a webcam, microphone and audio.
Travel arrangements should only be made after we have sent you the notification of acceptance. It is important that you know which travel documents are needed for you and your family to enter Canada:
Visa
Information on the visa application process can be found at the Government of Canada website. It is important that you know the visa processing time at the Canadian embassy in the country where you live.
Our office can provide you with a letter to support the visa application for your child and one accompanying parent/legal guardian. The letter will indicate:
- The reason for travel - your child will be receiving treatment at SickKids;
- The estimated cost of the treatment and that payment has been made or guaranteed;
- and the estimated length of stay for the treatment at SickKids.
Electronic Travel Authorization
Travelers from abroad who do not require a visa will need an electronic Travel Authorization (eTA), with the exception of U.S. citizens and those who have a valid visitor visa to Canada. Those who require an eTA must obtain it prior to traveling in order to be permitted to board their flight.
Please note: We cannot apply for a visitor visa or eTA on behalf of you or your child. However, if you require assistance you may contact us to guide you through this process.
The Herbie Fund
Some families may not have the financial means (e.g. private health insurance, ability to self-pay, or financial support from their government or embassy) to pay for treatment at SickKids. The Herbie Fund is a unique humanitarian fund at SickKids that provides eligible referrals with financial support for surgical care at SickKids.
Please refer to the eligibility criteria that outline who is considered an international patient at SickKids.
Your child is not an international patient if they are 18 years of age or older, OR is a:
- Non-Canadian person permanently living in Ontario.
- Non-Canadian who cannot provide proof of landed immigrant status. Please note you must be able to provide government documentation regarding application for landed status, refugee status to receive care at the hospital.
- Person who states they will permanently reside in Canada, or will re-establish residency in Canada, and will not return to their current country of residence after treatment is completed. Valid documentation regarding proof of their landed immigrant status/citizenship is required.
- Person who has applied for landed immigrant status after arriving in Canada. This can be determined with valid documentation of landed immigrant status.
- Refugee claimant awaiting Interim Federal Health Plan coverage (IFHP). You must provide a copy of your completed IFHP application to receive care.
If you have questions about whether your child is eligible for services at SickKids, you may contact us via email. Please provide the following basic information including:
- Contact Information
-
- Name
- Relationship to Patient: Parent/Legal Guardian or referring physicians
- Phone
- Patient Information
- Patient name
- Date of birth
- Country of residence
- Country of citizenship
- Diagnosis
- Payment method
- Service or treatment requested at SickKids
No. Completion of the referral form is the first step in the process. Please review the full intake process.
Once we receive your application completed in full and in English, we aim to have your application reviewed within 5 to 10 Canadian business days. Each application is individually reviewed by the appropriate SickKids medical experts, and therefore the time frame may vary if multiple SickKids doctors are involved. We will be in contact with you with a decision once your application has been reviewed by the medical team.
If your referral form is not completed in full and in English, or is missing supporting medical documentation, we will notify you or your child's referring doctor to request any missing information. Incomplete forms will not be processed until all required information is received, which in turn will delay your application being reviewed by the appropriate SickKids medical team.
At SickKids, we do our very best to ensure that the plan of care is specific for your child. Therefore, cost will depend on the specific service that will be provided. Please see detailed information about making financial arrangements to learn more about cost estimates and making payments.
When an international patient referral comes through the IPP office, we must gather information on a large number of medical and non-medical factors, one of which is the potential means of payment.
Canadian citizens who live abroad are subject to the principles for Ontario Health Insurance Program (OHIP) eligibility outlined by the Ministry of Health.
For international patients who have medical insurance to cover the costs of treatment, we require the following information prior to admitting a patient: the name of the insurance company, the policy number, the amount of the policy coverage, and a letter or guarantee of payment from the insurance company.
For families who have indicated that they will self-pay to cover treatment, we must understand the source of the funding, which usually means understanding parent income and number of dependents. We will respect your privacy and will use this information as part of the review process to ensure that the cost of treatment at SickKids will not negatively impact the long-term financial stability of the family as a whole, due to the financial burden that may be incurred as a result of the cost of treatment at SickKids. In addition, self-pay requires a full pre-payment of the treatment/assessment costs to SickKids before any treatment is scheduled and the patient is able to be admitted.
All financial information collected is held in the strictest confidence within our International Patient Program office.
Please refer to Visa & Electronic Travel Authorization Assistance.
There are many hotels and furnished apartments located within walking distance to SickKids. Please refer to the Information for International Patients and Families Visiting SickKids for more details. Please note that we will not book accommodations on behalf of patients and families.
Yes, valid travel health insurance for both the patient and accompanying family members is required by Immigration Canada in order to enter Canada. You may be asked by Immigration Canada officials for verification of travel health insurance when you arrive in Canada. Failure to produce evidence of travel health insurance may prevent your entry into Canada.
Toronto Pearson International Airport services the Greater Toronto Area. Most major international airlines have service there, often on a daily basis. We cannot make airline bookings on behalf of international patients, so speak with your travel agent to determine the best route for your travel to Toronto.
There are many fun and interesting things to see and do in the city, including art galleries, museums, concerts, Harbourfront (along Lake Ontario), the CN tower, the Science Centre, Toronto Zoo and great restaurants. Below are several links to attractions, tours in and around Toronto.
You can also refer to the Information for International Patients and Families Visiting SickKids booklet (PDF) for more resources to help you prepare for your visit to SickKids.
Contact us
Please see our FAQ section for quick answers to questions you may have.
The International Patient Program office is open Monday through Friday, from 8 a.m. to 4:30 p.m. EST. A representative from our team will review your message and contact you within 3-5 business days.
If you would like to meet with a member of our team in person to discuss your needs and concerns, please email us to make an appointment in advance. We are unable to accommodate walk-ins.
Phone: +1-416-813-7654 ext. 428917
Fax: +1-416-813-8667
After our normal business hours and on weekends, you may leave a message on our confidential voicemail system. Your voicemail message will be checked the following business day.
Email: international.patientprogram@sickkids.ca
Please note that email may be intercepted between the sender and the receiver and is therefore neither secure nor confidential. Your continued use of email communication confirms that you accept this risk.
We can serve you better if you can provide the following information when you contact us via email:
- Contact Information
- Name
- Relationship to Patient: Parent/Legal Guardian or referring physicians
- Phone
- Patient Information
- Patient name
- Date of birth
- Country of residence
- Country of citizenship
- Diagnosis
- Payment method
- Service or treatment requested at SickKids
If you would like to mail us required documents, please send them to the following address:
International Patient Program
The Hospital for Sick Children
555 University Avenue
Toronto, Ontario
Canada
M5G 1X8