Along with Family Medicine, we provide care in Cardiology, Cardiac Diagnostics, Urology, Dermatology, General Internal Medicine, Oculoplastic Surgery and Orthopedic Surgery.
Click here to download a fillable pdf of the Leaside Village Medical Clinic referral form. You can email it securely to firstname.lastname@example.org or fax it to (416) 745-1511. We also accept general referral letters from your EMR.
IMPORTANT NOTE: Although we use a secure and encrypted email service provider, we cannot completely guarantee the security of the information being sent via email due to the nature of the technology. If your patient has not consented to have their information sent via email, please send it via fax to: (416) 745-1511
We encourage you to reach out to your EMR provider and ask them to add our referral forms directly into your EMR environment as fillable forms. This way, you can fill them with patient info and fax them over, without ever needing to leave the patient chart. Our referral form is in the Accuro repository.
Please feel free to send us an email and loop us into any discussions with your software provider if you think we can help! We're here to support you however we can.