Category B

Botox

Clinic Location Referral Contact Information Dr. Marczuk, Dorota 595 Wonderland Rd NLondon, ON N6H 3E2 Patient self-referral, as well as provider referral via fax or emailBook free consultation directly onlineOptional: Physician referral form for Botox injections for chronic migraines Phone:…

Breast Care

Clinic Location Form Contact Information St. Joseph’s Breast Care Program SJHC D1-112 (Zone D Level 1) Breast Assessment Form Breast Surgery Form Phone: 519-646-6044 (breast care bookings is option 1)Breast Care Bookings Direct: 519-646-6100 ext. 66223Fax: 519-646-6204 Fax to SJHCWebsite  HPHA…

Body Maps

Full Body Map ASIA Spinal Cord Injury Worksheet Dermatome & Peripheral Nerve Body Map Face Map 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,…

Blood Transfusion Information

Informed Consent Quick Reference Guide Blood Transfusion Information Guide 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…

Billing

Emerg Billing Sheet EM Billing Sheet #1(PDF) EM Billing Sheet #2 (Excel) EM Billing Sheet #2 (PDF) EM Billing Sheet #3 (PDF) SGFP Billing Guide & List of Diagnostic Codes OHIP Schedule of Benefits OHIP Diagnostic Codes WSIB Physician Fee…