Pediatrics

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.

Share this

Fetal Risk Assessment from Maternal Exposure (FRAME) Program

LocationFormContactInformation
Safety of Medications in Pregnancy and Breastfeeding clinic800 Commissioners Rd E
London, ON N6A 5W9
Any referral form works
FRAME Fax Referral Form
Generic Form
Phone: 519-685-8500 ext 58293
Fax: 519-685-8156
Email: [email protected]
Website
Fax consult

Table of Contents

London

LondonSubspecialty / InterestLocationFormContactInformation
Dr. Al-Qadhi, Samim1. PediatricsThompson Medical Centre
130 Thompson Road
London, Ontario
N5Z 2Y6



Lucan Medical Centre
268 Main St P.O Box 310
Lucan ON
N0M 2J0
Generic FormPhone: London: 519-601-8621 ext 221
Phone Lucan: 519-227-1163
Fax: London: 519-204-3122
Fax Lucan: 519-227-1558
Fax consult
Speaks Arabic
Dr. Danby, Michelle1. Pediatrics499 Oxford St E
London, ON N5Y 3H8
Generic FormPhone: 226-289-3628
Fax: 226-298-2345
Fax consult
Dr. Gloor, Jane1. PediatricsSpringbank Medical Centre
460 Springbank Dr, Suite 206
London, ON
N6J 0A8
Generic FormPhone: 519-641-8687
Fax: 519-641-6518
Fax consult
Website
Dr. Gorodzinsky, Fabian1. Pediatrics
2. Behavioural Problems
3. Learning Disabilities
610 Colborne St
London, ON
N6B 2V2
Generic FormPhone: 519-672-4051
Fax: 519-672-4394
Fax consult
Dr. Jakobczyk, Jessica1. Pediatrics
2. Pediatric Headaches
Nixon Medical Centre
510 Southdale Rd E, Suite 301
London, ON
N6E 0B2
Generic FormPhone: 519-690-2806
Fax: 519-690-0970
Fax consult
Dr. Johnston, Maureen1. PediatricsSpringbank Medical Centre
460 Springbank Dr, Suite 206
London, ON
N6J 0A8
Generic FormPhone: 519-641-8687
Fax: 519-641-6518
Fax consult
Website
Dr. McNeely, Michael1. Pediatric Dermatology272 Oxford St W
London, ON
N6H 1S9
Generic FormPhone: 519-434-1112
Fax: 519-434-7950
Fax consult
Dr. Mohammed, Afzal1. PediatricsNixon Medical Centre – South London Children\’s After Hours Clinic
510 Southdale Rd E, Suite 310
London, ON
N6E 0B2
Generic FormPhone: 519-690-2806 ext 1
Fax: 519-690-2807
Fax consult
Dr. Mohammed, Javed1. Pediatric Dermatology510 Southdale Road East Suite 301
London ON
N6E 0B2
Generic FormPhone: 519-690-2806
Fax: 519-690-2809
Fax consult
Dr. Nagar, Rohit1. Pediatrics510 Southdale Road East Suite 301
London ON
N6E 0B2
Generic FormPhone: 519-690-2806 ext 2
Fax: 519-672-7888
Fax consult
Dr. Nanda, Sunit1. Pediatrics
2. Behavioural Disorders
185 Commissioners Rd W
London, ON
N6J 1X9
Generic FormPhone: 519-438-3296
Fax: 519-438-2912
Fax consult
Dr. Nasreen, Ruksana1. PediatricsChildren\’s After Hours Clinic
1653 Richmond St
London, ON
N6G 2M9
Generic FormPhone: 519-850-3800
Fax: 519-850-5099
Fax consult
Speaks Bengali
Website
Dr. Pavri, Daisy1. Pediatrics301 Wellington Rd
London, ON
N6C 4P1
Generic FormPhone: 519-673-6672
Fax: 519-673-6669
Fax consult
Speaks Gujarati & Hindi
Dr. Ramadan, Said1. Pediatrics611 Wonderland Rd N
London, ON
N6H 4V6
Generic FormPhone: 519-471-6686 ext 295
Fax: 519-471-2801
Fax consult
Speaks Arabic
Dr. Rouhani, Nassim1. Pediatrics
2. Behaviour Disorders (ADHD)
524 Oxford St E
London, ON
N5Y 3H7
Generic FormPhone: 519-601-6601
Fax: 519-601-6601
Fax consult
Website
Dr. Sethna, Mia1. PediatricsThompson Medical Centre
130 Thompson Road
London, Ontario
N5Z 2Y6
Generic FormPhone: 519-601-8621
Fax: 519-204-3122
Fax consult
Dr. Sottosanti, Maria1. Pediatrics
2. Pediatric Endocrinology
510 Southdale Road East Suite 301
London ON
N6E 0B2
Generic FormPhone: 519-690-2806 ext 5
Fax: 519-690-0970
Fax consult
Dr. Stare, Liga1. PediatricsSpringbank Medical Centre
460 Springbank Dr, Suite 206
London, ON
N6J 0A8
Generic FormPhone: 519-641-8687
Fax: 519-641-6518
Fax consult
Speaks Latvian
Website
Dr. Hashi, Ifrah1. PediatricsProudfoot Medical Clinic
524 Oxford St W #4
London, ON N6H 1T5
Dr. Hashi Referral LetterPhone: 519-473-5454
Fax: 519-474-0765
Fax consult

Regional

RegionalSubspecialty / InterestLocationFormContactInformation
Dr. Ahmed, Syed1. PediatricsElgin Paediatric Group
426 Talbot St, Suite 103
St Thomas, ON
N5P 1B9
Generic FormPhone: 519-637-8074
Fax: 519-637-2646
Fax consult
Speaks Hindi, Kashmiri, Urdu
Dr. Bertoldi, Margaret1. Pediatrics426 Talbot St, Suite 11
St Thomas, ON
N5P 1B9
Generic FormPhone: 519-637-0009
Fax: 519-637-5799
Fax consult
Dr. Hussain, Asmaa1. PediatricsElgin Paediatric Group
426 Talbot St, Suite 103
St Thomas, ON
N5P 1B9
Generic FormPhone: 519-637-8074
Fax: 519-637-2646
Fax consult
Speaks Arabic
Dr. Kerr, Paul1. PediatricsElgin Paediatric Group
426 Talbot St, Suite 103
St Thomas, ON
N5P 1B9
Generic FormPhone: 519-637-8074
Fax: 519-637-2646
Fax consult
Dr. Blaine, Kirsten1. PediatricsJenny Trout Centre
342 Erie St, Suite 113
Stratford, ON
N5A 2N4
Generic FormPhone: 519-272-2040
Fax: 519-272-2323
Fax consult
Dr. Gobburu, Ram1. PediatricsJenny Trout Centre
342 Erie St, Suite 113
Stratford, ON
N5A 2N4
Generic FormPhone: 519-272-2040
Fax: 519-272-2323
Fax consult
Dr. Mitchell, Nadine1. PediatricsJenny Trout Centre
342 Erie St, Suite 113
Stratford, ON
N5A 2N4
Generic FormPhone: 519-272-2040
Fax: 519-272-2323
Fax consult
Dr. Montiveros, Carolina1. PediatricsJenny Trout Centre
342 Erie St, Suite 113
Stratford, ON
N5A 2N4
Generic FormPhone: 519-272-2040
Fax: 519-272-2323
Fax consult
Dr. Pittman, Tina1. PediatricsJenny Trout Centre
342 Erie St, Suite 113
Stratford, ON
N5A 2N4
Generic FormPhone: 519-272-2040
Fax: 519-272-2323
Fax consult
Dr. Purushotham, Hemavathy1. PediatricsJenny Trout Centre
342 Erie St, Suite 113
Stratford, ON
N5A 2N4
Generic FormPhone: 519-272-2040
Fax: 519-272-2323
Fax consult
Speaks Tamil
Dr. Squires, Philip John1. Pediatrics
2. Behaviour Disorders (ADHD)
Jenny Trout Centre
342 Erie St, Suite 113
Stratford, ON
N5A 2N4
Generic FormPhone: 519-272-2040
Fax: 519-272-2323
Fax consult
Speaks French

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.