Please Note: The following documents are for use by healthcare professionals only. If you have a new version of a form to post please e-mail it to ahmadill@brightshores.ca.
Cardiac Rehabilitation
Cardiology
Diabetes
- Grey Bruce Diabetes Program Referral Form
- Diabetic Foot Ulcer Referral Form
- Dispensing of Insulin and/or Diabetes Injectable Therapy Protocolby Diabetes Educators
- Fasting Plasma Glucose and Lab/Meter Comparison Ordering Protocol for Diabetes Educators
- HgbA1C Ordering Protocol for Diabetes Educators
- Adult Insulin Dose Adjustment Protocol
Diagnostic Assessment Clinic
Geriatric
Lab Requisitions
Medical Assistance in Dying (MAID)
- MAID referral form to SW LHIN
- Clinician Aid A Form – for patient
- Instructions for Completing Clinician Aid A form
Medical Imaging
- CT Requisition
- General Medical Imaging Requisition
- Interventional Radiology Request
- MRI Breast Questionnaire
- MRI Requisition
- Mammography Breast Imaging Requisition
- Patient Preparation for Imaging Tests
- Request for Bone Mineral Densitometry
Mental Health and Addictions
Oncology
- Oncology Clinic New Patient Referral Form – Skin
- Oncology Clinic New Patient Referral Form – Lung
- Oncology Clinic New Patient Referral Form – Unknown Primary
- Oncology Clinic New Patient Referral Form – Breast
- Oncology Clinic New Patient Referral Form – Gastro
- Oncology Clinic New Patient Referral Form – Genitourinary
- Oncology Clinic New Patient Referral Form – Haematology