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Diabetes Referral Form
2024-04-02
Complete this form to refer or self-refer to the Provincial Diabetes Program or the Diabetes Drug Program.
Cardiac Rehab Referral Form
2022-01-19
Your physician or nurse practitioner can refer you to the Cardiac Rehab Program by submitting this referral form. An exercise stress test must be sent in with your referral. If you meet the inclusion criteria for the program, you will be contacted for an assessment...
Pulmonary Rehab Referral Form
2022-01-19
Your physician or nurse practitioner can refer you to the Pulmonary Rehab Program by submitting this referral form. If you meet the inclusion criteria for the program, you will be contacted for an assessment appointment.
For more information, visit the Cardiac and Pulmonary Rehab...
Demande de consultation en orthophonie
2021-10-04
Formulaire de référence pour que votre enfant soit vu par un orthophoniste.
All About Your Child - Speech Language Pathology Case History Form
2021-10-04
Case history for your child to be completed and returned to Speech Language Pathology before your initial appointment.
Demande de financement de traitement d’orthodontie pour les patients ayant une fissure palatine
2021-09-02
Veuillez remplir le présent formulaire pour demander un appui financier pour le traitement orthodontique d’une fissure palatine pour les enfants qui naissent avec cette malformation.