Geriatrics

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 WorldOSCAR or fill the contact form below for any other eForms that are not listed for your EMR.

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Clinics

ClinicServicesLocationFormContactInformation
Driving Assessment Program (Paid service)1. DriveABLE2. Driver Assessment and Rehab Program (DARP)Parkwood HospitalDrive Assessment FormPhone: 519-685-4070

Fax: 519-685-4066
Fax Referral
Website
Regional Geriatric Services Outpatient
1. Geriatric Consultation
2. Aging Brain & Memmory Clinic
3. Psychogeriatric Outreach 
4. Geriatric Program (office or home visit)
5. Continence Clinic
6. Geriatric Mental Health
7. Geriatric Day Hospital
8. Third Age OutreachInpatient
1. Geriatric Rehab Unit
2. MSK Rehab Unit
3. Acquired Brain Injury Rehab 
4. Spinal Cord Injury Rehab 
5. Stroke/Neuro Rehab 
Parkwood HospitalGAAT Referral Form (Outpatient)
Inpatient Geriatric Referral
Phone: 519-685-4046
Fax: 519-685-4020
Fax Referral for centralized intake
Please call access Office they are happy to discuss referrals
Outpatient Website
Inpatient Website
SJHC Osteoporosis Clinic1. Osteoporosis ManagementSt. Joseph’s Healthcare Centre
Room B4-084
SJHC Osteoporosis ReferralPhone: 519 646-6100 ext. 64434
Fax: 519 646-6183
Fax consult
Website

London Physicians

PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Borrie, Michael1. Geriatrician
2. Cognitive Impairment / Dementia
3. Geriatric Rehabilitation
Parkwood Hospital Main Building
550 Wellington Rd, A2-129
London, ON
GAAT Referral FormPhone: 519-685-4021
Fax: 519-685-4020
Fax consult
Dr. Diachun, Laura1. GeriatricianParkwood Hospital Main Building
550 Wellington Rd, A2-129
London, ON
GAAT Referral FormPhone: 519-685-4021
Fax: 519-685-4020
Fax consult
Dr. Kane, Sheri-Lynn1. GeriatricianParkwood Hospital Main Building
550 Wellington Rd, A2-129
London, ON
GAAT Referral FormPhone: 519-685-4021
Fax: 519-685-4020
Fax consult
Dr. Peel, Alexandrea1. GeriatricianParkwood Hospital Main Building
550 Wellington Rd, A2-129
London, ON
GAAT Referral FormPhone: 519- 685-4069
Fax: 519-685-4020
Fax consult
Dr. Wells, Jennie1. GeriatricianParkwood Hospital Main Building
550 Wellington Rd, A2-129
London, ON
GAAT Referral FormPhone: 519-685-4021
Fax: 519-685-4020
Fax consult
Dr. Thain, Jenny1. Geriatrician
2. Osteoporosis
LHSC – Victoria HospitalOsteoporosis Referral FormPhone: 519-685-8816
Fax: 519 646-6183
Fax consult
Dr. Brymer, Chris1. Geriatrician
2. Cognitive Impairment / Dementia
LHSC – University HospitalGAAT Referral FormPhone: 519-663-3922
Fax: 519-685-4020
Fax consult

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