Programs and Services

As a patient of the Burlington Family Health Team (BFHT) you have access to a number of FREE programs and services.  Many of our programs are underway and growing quickly, while others are under development.  We are committed to initiatives in the following fields:

  • Mental Health
  • Geriatric Care
  • Dietary Services
  • Chronic Disease Management

All of our programs and services are part of our Quality Improvement Plan.  As part of the provincial Excellent Care for All Act, each FHT must have a QIP which sets measurable goal for improvements in each program.  This report is submitted to Health Quality Ontario and is monitored internally by our Quality Improvement Committee.  For more information please refer to

While our programs are intended to address current health problems, they also have an educational component that, with time, will help with preventative measures for possible future health concerns.

Aging At Home


Aging at home

The Aging at Home program is an interprofessional program that provides community-based care to rostered patients from the Burlington Family Health Team.  The focus of this program will be on patients who have difficulty accessing the clinic. As a primary health care resource, the Aging at Home program will seek to link individuals with resources, educate patients, and provide care in the community.

What can we do for you:

  • Home or clinic visits
  • Physical assessments
  • Medication review
  • Medication management
  • Chronic disease management
  • Falls assessment
  • Mobility Assessment
  • Memory and cognition assessment
  • Referral to the Community Care Access Center (CCAC)

Do You Qualify?

  • Are you over 65 years of age?
  • A rostered patient of the Burlington Family Health Team?
  • Have a history of falling?
  • Suffer from chronic disease such as Congestive Heart Failure or COPD?
  • Have difficulty walking to and from your clinic appointments?
  • Have memory loss?

If so, speak to your Physician about a referral to the Aging at Home program at your next appointment!

Boosting Balance & Bone Health Program

Balancing Bone HealthThis 4 week program is designed to gradually improve balance and strength to avoid falls and maintain independence as well as educate individuals on keeping bones healthy.

The goals of the program include:

  • Understanding the basics of bone health, including how our bones are formed, what factors contribute to bone health, and the definitions of low bone mass and osteoporosis.
  • Learning different types of exercise most valuable to building bone health.
  • Reviewing daily requirements for calcium and vitamin D and how to get them from food products.
  • Identifying and implementing changes in your lifestyle to improve bone health.

Who is the Program for?

The program is for those who have issues with balance and/or have frequent falls and/or have been diagnosed with osteoporosis.  Individual must be able to walk ten meters with or without a walking aid.

When is it held?

The complete series consists of four weekly two-hour sessions. One hour is designated for group  exercise, and one hour is designated for education on bone health.  For the current schedule, please call the Burlington Family Health Team at 905-333- 8222 ext 267.

Where is it held?

The program is held at the Caroline Family Health Team (3305 Harvester Rd. Burlington, ON)

How much does it cost?

There is no cost for this program at this time.  The Boosting Balance and Bone Health Program was developed in partnership with the Osteoporosis Canada Break through program.  This program is led by Diane Dowdell and Leanne Fernandez, Registered Occupational Therapists.  To register please call Allison at the Burlington Family Health Team at(905) 333-8222 Ext. 267.  Enrollment is limited, and registration for each series is accepted on a first-come first-served basis.

*Please consult with your physician prior to signing up for the program should you have concerns regarding exercise

Diabetes Management Program

Through education, counselling and care, our diabetes management program is Physician/Nurse led and involves other members of the healthcare team through on-going regularly scheduled visits.  The goal is to empower our patients with diabetes to be self-directed in learning the skills and behaviours needed for successful self-management of diabetes.

When are the visits?

There is one diabetic Clinic Day per month per Physician practice. Dates are based on practice – please call the clinic to inquire.

What to expect during your appointment?

During your appointment on the diabetic Clinic Day, you will meet with the nurse, the Dietitian, the Pharmacist and your Physician for an all-encompassing visit as all aspects of the diabetes management will be covered.  This visit will also include patient education in areas such as glucose control, taking medications, healthy eating, foot care, eye care, exercise, and more.  Once you have had your initial visit, you will attend these Clinic Days on a regular basis (every 3-6 months).

Interested in booking an initial diabetic visit?

If you are interested in making an appointment on a Diabetic Clinic Day, please call the office at 905-333-8222 and request a time slot during your doctor’s Diabetic Clinic Day.

If you are unable to make an appointment on a Diabetic Clinic Day, but are looking for more information about how to manage your diabetes, there are a number of options for you:

  • Book an appointment with the Nurse Practitioner
  • Book an appointment with your family doctor
  • Ask for a referral to the Halton Diabetes Program to take advantage of the many groups they are already offering our patients

Follow-up Visit(s)

Follow up visits on future Diabetic Clinic Days will be determined by your physician and can be booked in the clinic after your appointment.


Dr Mike Evans – “ABC’s of Diabetes

Mental Health Services

Mental Health Services

Burlington Family Health Team is (BFHT) committed to promoting mental health education, wellness and services. BFHT employs full and part-time Masters level Registered Social Workers.

You and your family may access social work support provided that you are a rostered patient and have met with your family doctor to review your needs and for a referral to be generated.

Your BFHT Social Worker may help you in the following ways:

  • Counselling and/or support using a range of therapeutic modalities (for example, cognitive behaviour therapy, dialectical behaviour therapy, grief counselling, addiction recovery support, stress management strategies, assistance with return to work and/or school, understanding and coping with physical and mental health challenges, etc.)
  • Assistance with referrals to community resources
  • Advocacy support to access and liaise with supports in the community
  • Case management services
  • Crisis management support

Burlington Family Health also has access to direct and indirect psychiatric support on a referral and consultation basis.

Caroline Families First Program

  • The Ministry has provided funding for the expansion of the Caroline Family Health Team’s Caroline Families First Program to include patients of our team.
  • This model of care is for children (2-21 years of age) and families who are struggling with multiple, complex and ongoing challenges. At its simplest, the Caroline Families First program is a family driven, team based planning process that develops individualized plan that uses the strengths of the family and their team members to develop strategies that the whole team takes on.
  • Proposed outcomes include: improved functioning in the home, increased community and natural supports, decreased stress for the child and family and increased communication regarding the child’s needs.

Please contact your Family Physician about a referral to social work and psychiatric services.


Nutrition Counselling

What is a Registered Dietitian?

A Registered Dietitian (RD) is a recognized health professional in the field of food and nutrition. Dietitians are an invaluable resource, as they clarify the complex relationship between food and health. A Dietitian is a key player in helping you achieve better overall health and prevent future illness. As nutrition experts, Dietitians can provide trusted advice on dietary choices to make it easier for you to plan healthy, balanced meals and achieve your personal goals.

What is the difference between a Registered Dietitian and a Nutritionist?

The terms Dietitian and Nutritionist are often used interchangeably; however, there is a big difference between these roles. In Ontario, the titles ‘Registered Dietitian’ or simply ‘Dietitian’ are legally protected terms. This means that only individuals who have met specific educational and professional criteria are allowed to use these titles.

To become a Registered Dietitian, an individual must complete a four year university degree in the field of food and nutrition, complete one additional year of practical training (or internship), and also successfully pass the Canadian Dietetic Registration Exam. To ensure public protection, every Registered Dietitian in Ontario is also required to be a member of the College of Dietitians of Ontario. With membership, Dietitians are closely regulated and must practice according to a specific set of standards, ethics, and laws.

In contrast, the terms ‘Nutritionist’ or ‘Registered Nutritionist’ are not legally protected titles. Nutritionists are not monitored through a regulatory body or associated professional college. As such, there is no set standard regarding educational background or quality of care.

How can a Registered Dietitian help?

A Registered Dietitian can help you address a variety of nutritional concerns including the following:

  • Weight control
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Heartburn / Reflux
  • Bowel management (for example, constipation)
  • Celiac disease
  • Ulcerative colitis or Crohn’s disease
  • Osteoporosis
  • Food allergies & intolerances
  • Preconception and pregnancy nutrition
  • Picky eating
  • General healthy eating strategies & food label reading
  • Eating on a budget

What should I expect from an appointment with the Registered Dietitian?

Depending on the complexity of your nutritional concerns and stated goals, you may only need to meet with the Dietitian for 1 or 2 sessions. However, for many common nutritional issues (such as high cholesterol and weight loss), more frequent nutrition appointments may be required to thoroughly address your health concerns. You may be asked to continue meeting with the Dietitian for a period of up to 12 months.

For your very first appointment, the Dietitian will review a nutrition questionnaire and 3-day food record with you. This will help her better understand your health and weight histories, general lifestyle, eating habits, food preferences, and physical activity level. Individual goal setting will be a priority and nutrition education pertaining to your specific dietary concerns will start being addressed. Plan on spending roughly 1 hour at this appointment.

At follow-up sessions, you will be asked to bring written records of your food intake (usually 2 or 3 days of recent dietary intake). This will provide the Dietitian with the most up-to-date information. She will also continue to offer nutrition education as required and assist you with setting new dietary and physical activity goals. Expect each follow-up appointment to last approximately 30 minutes.

How can I see the Burlington Family Health Team Dietitian?

Referrals are granted for patients rostered with the Burlington Family Health Team only. Either speak to your family doctor, Nurse Practitioner, or other allied health professional and ask for a referral to set up a visit with the Dietitian.

How much does it cost to see a Registered Dietitian?

If you are a rostered patient with the Burlington Family Health Team, OHIP will cover the charge of your visit(s) with the Dietitian.

External Resources : Nutrition


Occupational Therapy Services

What is an Occupational Therapist?

Occupational Therapists (OT) work with people who experience barriers to participation in day to day occupations (self-care, household management, work, school and leisure) as a result of injury, illness, mental health problems, aging, developmental problems, social disadvantage.  With the patient, they identify solutions to remove or minimize barriers and promote or maintain function.

Occupational Therapists use a variety of approaches such as health promotion, injury prevention, chronic disease management, direct services and community development.

How can an Occupational Therapist help?

An Occupational Therapist can help you address a variety of concerns including:

Balance and Mobility:

  • Falls Prevention, Balance and Mobility Assessment
  • Balance and strengthening exercise program


  • Memory Assessment
  • Cognitive/Dementia Screen
  • Better Living for your Brain program


  • Recommendation of Adaptive Aids/Assistive Devices
  • ADP funding for mobility devices
  • Caregiver support/Strategies for home management
  • Community Resource Linkage (i.e. Multiple Sclerosis Society of Canada, Alzheimer’s Society, Adult Day programs, Accessibility)
  • Basic Functional Assessment
  • Ergonomic Assessment
  • Occupational Issue (i.e. self-care management, work, leisure)

How can I see the Burlington Family Health Team OT?

Presently Occupation Therapist services are only available to patients of physicians at the Halton McMaster Family Health Centre.  We will be expanding this service to patients of Burlington General Practitioners in Fall 2018.  More information will be posted on our website nearer to that date.

External Resources:

Mobility Device- ADP program

Adult Day Programs

Sit to be Fit Classes- Burlington



Smoking Cessation

Giving up smoking is the single most important thing you can do for your health!

Our Cessation Program offers Nicotine Replacement Therapy (NRT) – patch, gum, inhaler, lozenge – at no cost and counseling support to Family Health Team Patients who want to quit.

How to Join

Ready to quit?
If you are interested in quitting smoking and want to join the program, please call the office at 905-333-8222 and ask to speak with Corrie.  You may also speak to your family doctor at your next visit.

Thinking of quitting?
To discuss reduction strategies or to talk about the possibility of quitting, call at 905-333-8222  and speak with Corrie.

About the STOP program

The STOP with Family Health Teams (FHTs) is an Ontario-wide program designed to help people reduce or quit smoking. A key element of the program is to facilitate access to nicotine replacement therapy (NRT).

Studies  have shown if you want to read more) that NRT, used in conjunction with smoking cessation counseling, is effective in helping people reduce and quit smoking.

To join the program you need to be a patient of the Family Health Team. Also, note that the specific NRT products Wellbutrin/Zyban and Champix are not available through the program – but may still be considered as part of your quit plan!

What to expect

The initial visit
Lasting at least 60 minutes, we will review your current smoking habits and situation, and form a “quit plan”. We will provide you with NRT products if it is part of your quit plan.

Follow-up Visit(s)
Please plan about 30 minutes for each of your follow-up visits. We will review your plan and progress, and make any changes or suggestions that might increase your chances of success. NRT products will be dispensed during the visit.
Please note that NRT is only available through regular STOP visits – we can’t provide NRT on a walk-in basis as there is no evidence that this is effective, and it is not how the STOP program works!


Cancer Screening – Breast

What Is Breast Cancer Screening?


breastcancer_adjThe goal of breast cancer screening is to detect cancer early and provide treatment. Mammography is currently the recommended test used to detect breast cancer.

It is important to find breast cancer early because:

  • There is a better chance of treating the cancer successfully
  • It is less likely to spread
  • There may be more treatment options
  • When breast cancer is caught early, 90% of women fully recover after treatment

The Ontario Breast Screening Program (OBSP) – a program administered by Cancer Care Ontario – provides mammography screening for women at average risk of developing breast cancer aged 50 years and older.
Now, women aged 30-69 who are found to be at high risk for developing breast cancer will also have access to OBSP services including annual mammography and breast MRI screening.

Overview: OBSP

First established in 1990, the Ontario Breast Screening Program (OBSP) provides high quality breast cancer screening services to women living in Ontario. It is operated by Cancer Care Ontario and funded by the Ontario Ministry of Health and Long-Term Care.

The OBSP currently accepts women who fall into the following two categories:

  1. Women at average risk of developing breast cancer, age 50 and over:

Evidence shows that regular mammograms for women who are at average risk and 50 years or older, are the most effective way to detect breast cancer early. Average risk means you have no other risk factors simply than being a woman and being older (i.e. 50 and over).

  1. Women at high risk of developing breast cancer, age 30 to 69:

As of July 1 2011, women in Ontario aged 30 to 69 who are at high risk for breast cancer due to genetic factors or a personal or family history suggestive of hereditary breast cancer can receive an annual breast screening MRI and mammogram through the OBSP.

How to get a mammogram:

  • All physicians in our Family Health Team are members of the OBSP
  • When you go for your first mammogram, you will automatically be entered as part of the OBSP.  You will receive reminder letters for your screening from the program, and copies of your test results are sent to your family doctor to review.
  • Women aged 50 and over who are at average risk may refer themselves to the OBSP. To self-refer, please call an OBSP site directly to make an appointment.
  • Women between the ages of 30 to 69 who are at high risk will need a referral from their doctor or Nurse Practitioner to be screened at an OBSP centre.

Appointment information

If you are a female between the ages of 50 and 74 in our Family Health Team, you are already a participant of the OBSP.   Letters will be sent to you by the OBSP indicating how and where to book your appointment. After your appointment, follow up letters will be sent to your home indicating the time interval for your next screening date.  Your family doctor will review all results, and a call will be given if any follow up is needed.


You will receive 2 letters from the OBSP. The first letter will prompt you to book either your first appointment, or to book any follow-up appointments.  There will be a second reminder letter sent, if you do not book your appointment after receiving the first letter.

Diagnostic Image Locations

If you need to book your mammogram, the following imaging locations are part of the OBSP.  If you do not have a requisition, you will need to call your doctor’s office to obtain one before booking your appointment.

– Burlington Ultrasound and Radiology
– Joseph Brant Memorial Hospital
– Halton X-ray and Ultrasound

Cancer Screening – Cervical

Cervical Cancer Screening

Regular screening is an essential defense against cervical cancer. Cervical cancer screening can detect early cell changes on the cervix caused by persistent human papillomavirus (HPV) infection. These changes seldom cause any symptoms, but can progress to cancer if not found and treated. Screening is the only way to detect changes that might lead to cancer.


The cervical cancer screening program is run out of our office.  All eligible female patients between the ages of 21 to 70 are eligible participants. Prevention and early detection are the key objectives. Cervical cancer screening with PAP tests can detect cell changes and precancerous lesions associated with persistent infection with high-risk types of human papillomavirus.

All women should have regular PAP tests starting at age 21 if they have a known history of any kind of sexual activity and are eligible for them every 2 years. PAP tests can find cell changes early, long before there are any symptoms and before a diagnosis of cancer. With regular PAP tests and the HPV vaccine, it is possible to prevent cervical cancer.

Appointment information and Follow-up

Appointments for your PAP testing can be made by calling the clinic at 905-333-8222.  You can request a female health care provider for your PAP testing and results are available 4-6 weeks after your test.  Your Physician will review them and you will be called if any follow up is required.

HPV Vaccine

The HPV vaccine is a major breakthrough in cancer prevention. The HPV vaccine Gardasil is the vaccine used in Ontario’s HPV immunization program. The vaccine protects against four types of HPV — types 6, 11, 16 and 18. Two of these cause 70% of cervical cancers and the other two cause 90% of genital warts.

Three doses of the vaccine are required for complete protection. The HPV vaccine has been approved for use in over 100 countries, and over 40 million doses of vaccine have been distributed worldwide. The HPV vaccine is approved for females aged 9 to 45 and for males aged 9-26.

HPV immunization as well as regular PAP tests (starting at age 21) can reduce the risk of cervical cancer in women. (From Ontario Ministry of Health and Long-Term Care Website)


Dr. Mike Evans – “Should You Get the HPV Vaccine”?

Cancer Screening – Colon

Download Colon Cancer Screening PDF

Download Colon Cancer Screening PDF

What is Colorectal Cancer?

Colorectal cancer refers to cancer of the colon or rectum. The colon, which is also called the large intestine or large bowel, is a hollow tube five to six feet long and is coiled within the abdomen. The rectum is the last six inches of the colon. This is not a part of our bodies we spend a lot of time thinking about and certainly not talking about, but the colon is a hardworking organ that helps our bodies absorb water and excrete waste.
Cancer in the colon or rectum can take up to 10 years or more to develop to an advanced stage. This is why it is very important to make regular screening for colorectal cancer a part of your routine health checks.

Fecal Occult Blood Testing (FOBT)

The Fecal Occult Blood Test (FOBT) is the screening method for average risk people between the ages of 50 and 74. It is a simple test that you can do in the privacy of your home. The FOBT is the most widely available test for screening for colorectal cancer.

It is recommended that men and women between the ages of 50 and 74, who do not have a family history of colorectal cancer and do not have symptoms, be screened every two years using an FOBT. Studies show when this screening test is performed every two years, combined with a colonoscopy for those who test positive, it will reduce death from colorectal cancer by 16 per cent over a decade.  (From Ministry of Health and Long-Term Care Website)


An FOBT kit can be given to you the patient at the office to take home. You need to have a requisition inside of your FOBT kit in order to send it to the lab for testing.  You can get your requisition and kit at a regular patient appointment, at the nursing clinic, or if you call to pick one up.

Appointment Information and Follow-up

Your test results for FOBT test will be sent directly to your Physician to review. If any follow-up is needed you will receive a call from your doctors office.

External Resources: Cancer Screening – Colon


Medication Review Program

Our Clinical Pharmacist works with Physicians and other health care providers within the Burlington Family Health Team to ensure you are getting the most from your medications. As part of the Meds Review Program, there is an initial hour long patient medication assessment that can include your spouse or caregiver, and will review all the medications you are currently taking, including all prescription medications, over the counter and herbal products.

This assessment is intended to identify any drug related issues, including drug interactions, side effects and timing of medications.

The Clinical Pharmacist will then work with your doctor and community Pharmacist to resolve these concerns and simplify your drug regimen. This might be particularly beneficial for patients on multiple medications, from several different prescribers and/or those patients recently discharged from hospital to make sure there is no duplication in therapy.

Our Clinical Pharmacist also supports many of our patient care programs including diabetes, COPD, asthma, healthy heart, mental health, chronic pain and smoking cessation and has access to a number of tools and resources to assist you in managing your health.

No referral is required for this program. To book an appointment, please call the clinic at 905-333-8222 and ask to see the Pharmacist. The Clinical Pharmacist currently works Monday and Thursdays.

Advice For People Taking Opioid Medication