Get Canada Ottawa Gastrointestinal Institute Referral Form 2015-2025

Filling out the Canada Ottawa Gastrointestinal Institute Referral Form online can be a seamless process with the right guidance. This comprehensive guide provides you with step-by-step instructions tailored to help you complete the referral form accurately and efficiently.

Follow the steps to complete your referral form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by entering the patient’s full name in the designated field. This should include the first name, middle initial (if applicable), and last name.
3. Enter the date of referral to document when the form is being completed. This is important for record-keeping.
4. Provide the patient’s date of birth. Ensure the format is correct to avoid any discrepancies.
5. Indicate the patient's gender by selecting M or F as appropriate.
6. Fill in the referring medical doctor's name in the 'Referring MD' section to ensure the form is processed by the right healthcare provider.
7. Include the patient's OHIP number to verify their health insurance coverage.
8. Provide the billing number for administrative purposes.
9. Enter the patient’s current address, along with their phone number, cell number, and fax number if applicable.
10. Fill in the patient's email address and the office email of the referring doctor to facilitate communication.
11. Check or circle all applicable medical history and reasons for referral. This section is crucial for understanding the patient’s medical background.
12. Document any medications the patient is currently taking to assist with treatment planning.
13. Detail any relevant surgical history, including past procedures that may impact care.
14. Attach any other past medical documentation necessary for review, such as previous colonoscopy or EGD reports.
15. Review all information entered for accuracy before submission.
16. Save changes, download, or print the form for your records. You may also share it as needed.

Complete your documents online to ensure a smooth referral process.