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.
Table of Contents
Clinics
FP-Dermatology
| FP-Dermatology | Location | Form | Contact | Information |
|---|---|---|---|---|
| Dr. Howard, Jessica | Middlesex Centre Regional Clinic Box 160, 36 Heritage Drive, Ilderton, Ontario, N0M 2A0 South Huron Hospital (Exeter)/ Charlotte Eleanor Englehart Hospital (CEEH) – Petrolia | Skin Disorders Clinic | Phone: 519-666-1610 ext 208 Fax: 519-913-2899 | Fax Consult Website |
| Dr. Bhanji, Tania Dr. Market-Walmsley, Marisa | PureSkin Dermatology 2-3090 Colonel Talbot Rd. London, ON N6P 0B3 | PureSkin Dermatology | Phone: 519-432-6556 Fax: 519-913-5171 | Fax Consult Website |
| Dr. Hameed, Saadia | 346 Platt’s Lane, London, ON N6G 1J1 | Generic Form | Phone: 519-672-9660 Fax: 519-672-7727 | Fax Consult |
| Dr. Bezaire, Martin | 770 South Wenige Dr, London, ON N5X 4K3 | Generic Form | Phone: 519-679-1717 Fax: 519-679-1716 | Fax Consult |
| Dr. Hunter-Orange, Jessica Dr. Andrade, Jennifer | 202-460 Springbank Drive London, ON N6J 0A8 | Generic Form | Phone: 519-913-3500 Fax: 519-913-3709 | Fax Consult |
| Dr. Tripp, Julie Dr. Toft, Ian | London Skin Disorder Clinic 990 Gainsborough Rd, London, ON N6H 5L4 | Generic Form | Phone: 519-601-8621 EXT 101 Fax: 519-204-3122 | Fax Consult |
| Dr. Rubab, Faria | 303-510 Southdale Road East, London, ON N6E 1A5 | Rubab Dermatology | Phone: 519-850-3999 Fax: 519-937-1693 | Fax Consult |
| Dr. Kaschor, Brenna Dr. Lepitre, Michelle | PRISMA HCC – PCSP Clinic 320 Adelaide St S, London, ON N5Z 3L2 | Submit referral through Ocean eReferral or send referral webform online | Phone: 519-878-8621 Fax: 519-913-4045 | Website |
Pediatric Dermatology Physicians
| Paediatric Dermatology | Location | Form | Contact | Information |
|---|---|---|---|---|
| Dr. Mohammed, Javed | Nixon Medical Centre 510 Southdale Rd E, Suite 301 London, ON N6E 0B2 | Generic Form | Phone: 519-690-2806 Fax: 519-690-2809 | Fax Consult |
| Dr. McNeely, Michael | 272 Oxford St W London, ON N6H 1S9 | Generic Form | Phone: 519-434-1112 Fax: 519-433-7950 | Fax Consult |
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