Referral Form
Referral information for physicians and healthcare providers referring patients to Internal & Respiratory Medicine Specialty Clinic.
Referring a patient
Internal & Respiratory Medicine Specialty Clinic welcomes referrals from physicians and other healthcare providers for adult patients requiring specialist assessment in internal medicine or respiratory medicine. A completed referral form helps our team review the relevant clinical background and determine the appropriate next steps for the patient's care.
What to include
To help us process referrals efficiently, please ensure the following information is included where available:
- Patient demographics and contact information
- Reason for referral and relevant clinical history
- Recent investigations, imaging or laboratory results
- Current medications and allergies
- Referring provider details and contact information
Download the Referral Form
Download the clinic referral form to include with your patient referral. Please ensure all relevant clinical information is provided so our team can review the referral efficiently.
Need to Refer a Patient?
Referring providers are welcome to direct patients to our secure online booking system for the Brampton or Mississauga location.
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