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. Lovegrove, FionaOxford Health Centre
140 Oxford St E, Suite 207
London, ON N6A 5R9
Lovegrove Derm Referral

Psoriasis / Atopic Dermatitis Fast-Track Referral Form
Phone: 519-204-3959
Fax: 519-438-2400
Fax Consult
Dr. Cowger, JeffAdvanced Medical Group – Skin Therapy Centre
230 Victoria St
London, ON
N6A 2C2
Generic FormPhone: 519-873-1447
Fax: 519-873-1448
Fax Consult
Dr. Guenther, Lyn835 Richmond St
London, ON
N6A 3H7
Generic FormPhone: 519-435-1738
Fax: 519-435-1740
Fax Consult
Dr. Gupta, Aditya645 Windermere Rd
London, ON
N5X 2P1
Generic FormPhone: 519-657-4222 x 221
Fax: 519-657-4233
Fax Consult
Dr. Horgan-Bell, Caroline1055 Fanshawe Park Rd W
Suite 202
London, ON  N6G 0W7
Generic FormPhone: 519-641-0002
Fax: 519-641-0040
Fax Consult
Dr. Wexler, DeniseDermEffects
1560 Hyde Park Rd
London ON  N6H 5L5
Generic FormPhone: 519-900-5668
Fax: 519-472-8484
Fax Consult
Dr. Loo, WeiDermEffects
1560 Hyde Park Rd
London, ON
N6H 5L5
Generic FormPhone: 519-472-8686
Fax: 519-472-8484
Fax Consult


Dr. Howard, Jessica
Dr. Bhanji, Tania
Dr. Wilson, Emily
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 ClinicPhone: 519-666-1610 ext 208
Fax: 519-913-2899
Fax Consult
Dr. Hameed, Saadia346 Platt’s Lane,
London, ON
N6G 1J1
Generic FormPhone: 519-672-9660
Fax: 519-672-7727
Fax Consult
Dr. Bezaire, Martin770 South Wenige Dr,
London, ON
N5X 4K3
Generic FormPhone: 519-679-1717
Fax: 519-679-1716
Fax Consult
Dr. Hunter-Orange, Jessica
Dr. Tripp, Julie
Dr. Andrade, Jennifer
Dr. Toft, Ian
London Skin Disorder Clinic
990 Gainsborough Rd, London, ON N6H 5L4
Generic FormPhone: 519-601-8621 EXT 101

Fax: 519-204-3122
Fax Consult
Dr. Rubab, Faria303-510 Southdale Road East,
London, ON
N6E 1A5
Rubab DermatologyPhone: 519-850-3999
Fax: 519-937-1693
Fax Consult
Dr. Velker, BrennaThompson Medical Centre,
130 Thompson Rd,
London, ON
N5Z 2Y6
Generic FormPhone: 519-601-8621
Fax: 519-204-3122
Fax Consult

Pediatric Dermatology Physicians

Paediatric DermatologyLocationFormContactInformation
Dr. Mohammed, JavedNixon Medical Centre
510 Southdale Rd E, Suite 301
London, ON
N6E 0B2
Generic FormPhone: 519-690-2806
Fax: 519-690-2809
Fax Consult
Dr. McNeely, Michael272 Oxford St W
London, ON
N6H 1S9
Generic FormPhone: 519-434-1112
Fax: 519-433-7950
Fax Consult

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