• Ch-1300 Grief and Bereavement Referral Form (PDF, Editable, 2019)

• Ch- 2174 Autologous Sperm Cryopreservation Requisition fillable (PDF, 2020)
  
• Ch- 022 Microbiology Referral Form (PDF, 2016)
• Ch- 0618 Pathology Specimen Requisition Form (PDF)
• Ch- 0764 Constitutional Cytogenetics Requisition Form (PDF, 2017)
• Ch- 0771 Flow Cytometry Requisition Leukemia/Lymphoma Investigation (PDF, 2018)
• Ch- 1193 Cytogenetics Requisition for Amniocentesis Form (PDF)
• Ch- 1357 Cytology Non- Gyn Requisition (PDF, 2017)
• Ch- 1413 Placental Pathology Requisition (PDF, 2017)
• Ch- 1652 Postnatal Microarray Requisition Form (PDF)
• Ch- 1854 Public Health and Microbiology Specimen Collection Requisition (PDF, 2018)
• Ch- 2080 Semen Analysis Requisition (PDF, 2019)
• R001 Ch-0177 Laboratory Medicine Provincial Requisition Form (Outpatient Specimen Collection) (PDF)
• R0011 Molecular Genetics Laboratory Requisition Form (PDF, 2019)
• R0005 Ch-1372 Maternal Serum Screen Requisition Form (PDF, 2019)
• R0019 Laboratory Test Special Authorization Form (PDF, 2019)

• R0017 Rheumatology Patient Referral (Feb, 2021 PDF)
  

Neurology

• Ch-1918  Neurology Outpatient Referral Form (PDF. March 2019)

• Ch-0987 Schedule for Elective Surgery (PDF)
• Ch-0985 Checklist for Completion of O.R Booking Package (PDF)

Bariatric Surgery

• Ch-1577 Bariatric Surgery Booking Form (PDF, May 2017) 

Orthopedic Services

• Ch-0983 Orthopedic Central Intake Patient Referral Form (PDF)
• Ch-1241 Request for Spine Consultation Orthopedic Central Intake (PDF) 

Other Resources:

• Orthopedic Central Intake (OCI) Update for Referring Physicians (PDF)
  
• Orthopedic Central Intake Patient Information Sheet (PDF)

Pastoral Care and Ethics

• Ch-1225 Request for an Ethics Consultation Form 2013 (PDF)

Other Resources:

• Accountability for Reasonableness (A4R) (PDF): An ethics and values based framework for the planning, priority setting, and allocation of resources of programs and departments.

• Ch-0787 Printing Requisition Form (PDF)

• Center for Pain and Disability Management Form (PDF)
• Ch-1383 Rehabilitation Day Services Referral Form (PDF)

Pulmonary Rehabilitation

• Ch-1397 Pulmonary Rehabilitation Referral Form (PDF, April 2018)