All referral forms on this website are also available as eForms for OSCAR, Avaros, Indivicare, and ACCURO EMRs. You can download some of the premade forms here from WorldEMR or fill the contact form below for any other eForms that are not listed for your EMR.

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Dr. Marczuk, Dorota595 Wonderland Rd N
London, ON N6H 3E2
Patient self-referral, as well as provider referral via fax or email
Book free consultation directly online

Optional: Physician referral form for Botox injections for chronic migraines
Phone: 519-488-1951
Email: [email protected]
Botox including for migraines, Botox for Hyperhydrosis/Excessive sweating, Eyelashes Enhancement/hypotryhosis treatment with Latisse

Need eForms for your EMR system? EMR training? IT services? Online booking? Check-in kiosk? Contact us
Get all the London-area eForms for OSCAR, JUNO, Avaros, THT, Indivicare here
Contact [email protected] for any other eForm needs for OSCAR, JUNO, Avaros, THT, Indivicare, and Accuro EMRs.