Referrals
If you are a physician and would like to refer a patient, please complete the form below. Before submitting, please review the CCO guidelines and Exclusion Criteria.
Forms to Complete for referral
If you are a physician and would like to refer a patient, review and complete the form below. Please fax the completed form to 519-433-4702.
Important Notice: Please be aware that London Scoping Centre does not arrange or provide interpreter services for patients. It is essential for the patient to organize their own interpreter or coordinate with the Referring Provider’s office to ensure proper arrangements are made.