Lakeridge Health Gynecologic Oncology Referral eForm

Provided by Leo Pavone
Open Source Electronic Medical Records Software
Open Source Electronic Medical Records Software

Provided by Leo Pavone

Provided by Leo Pavone

The fax number has changed. I have written a line to overwrite the old number with the new one. 2020-Sep-08 15:54. This form was created by Jan Nusche with some additions by myself (John Robertson)

2020-Feb-06 19:57 Level of Urgency Table is now clickable. Created by James Saunders. Referral to the Gynecologists working in the Vancouver Island Health Region in and around Victoria

This is the new form for referral to BCWH RPL. It has some required fields and some colour changes when “sub Xboxes” are required. JohnR

Created for Colposcopists working with the BC Cancer Agency.

Referral form to Dr. Geoffrey W. Cundiff and Dr. Roxana Geoffrion at the Centre for Pelvic Floor Competence. Referral form toggles between the 2 surgeons and their areas of expertise.