Referrals and Requisitions
This section is for Health Care Professionals to utilize only.
This page provides access to referral / requisition templates utilized at OSMH. We will also accept referral / requisitions not on the hospital template if they provide all information required to identify the patient, the referring clinician, the procedure requested and pertinent details. Any incomplete or illegible referrals / requisitions will be sent back to the referring provider requesting further information before a procedure can be scheduled.
Diagnostic Imaging now accepts eReferrals! Please check the OCEAN Health Map for more information.
If you are a primary care provider and want to sign up for OCEAN eReferral, complete the online quick form or email eReferral@ehealthce.ca.
Referral / Requisition Forms:
Click Here for our OSMH Acute Cardiac Evaluation Services Form
Click Here for our OSMH Anesthesia Procedural Clinic Referral Form
Click Here for our Anesthetic Consult Request Referral Form
Click Here for our Asthma Referral Form
Click Here for our Cardiac Diagnostics Referral Form
Click Here for our Cardiac Rehabilitation Referral Form
Click Here for our Cardioversion Request Form
Click Here for our CHAT Referral Form
Click Here for our Couchiching Ontario Health Team Care Clinic Referral Form
Click Here for our CT Exam Form
Click Here for our EEG Requisition Form
Click Here for our General Genetics Referral Form
Click Here for our Cancer Genetics Referral Form
Click Here for our Interventional Procedure Form
Click Here for our Mammography Bone Density Exam Form
Click Here for our Mental Health Outpatient Services Referral Form
Click Here for our Nuclear Medicine Exam Form
Click Here for our MSK-CI-Referral Form
Click Here for our Outpatient Rehabilitation Services Referral Form
Click Here for our Paediatric Eating Disorder Program Referral Form
Click Here for our Remdesivir Referral Form
Click Here for our Respiratory Testing Referral Form
Click Here for our Surgery Booking Request Form - OSMH Surgeon Use Only
Click Here for our Telederm Referral Form
Click Here for our Ultrasound Exam Form
Click Here for our Videoflouroscopy Referral Form
Click Here for our XRAY Exam Form
If you should require a referral form not listed above, please contact the phone number below.
General questions about patient scheduling can be directed to 705.325.2201 option 3.
Should you have questions about Central Scheduling and/or Scheduling practices at OSMH, please contact central scheduling or registration at 705-325-2201 Ext: 8001