Internal Medicine

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

Clinics

ClinicServicesLocationFormContactInformation
Victoria Hospital ER Urgent Medicine1. Urgent Medicine Clinic LHSC – Victoria HospitalVH Urgent Medicine Referral VH ER Urgent Medicine Pt HandoutFax: 519-685-8751-Clerk to Book
-Fax consult with ER Sheet
-*VH ER Only*
University Hospital ER Urgent Medicine1. Urgent Medicine Clinic LHSC – University HospitalUH ER Urgent Medicine Referral UH Urgent Medicine Pt HandoutFax: 519-663-3414-Clerk to Book
-Fax consult with ER Sheet
-*UH ER Only*
St. Joseph’s Hospital UCC Urgent Medicine1. Urgent Medicine Clinic St. Joseph’s Healthcare CentreSJ UCC Urgent Medicine ReferralFax: 519-646-6064-Fax consult with ER Sheet
-They will call patient
-*SJHC UCC Only*

University Hospital – London Physicians

University Hospital PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Appleton, Andrew1. Internal MedicineLHSC – University HospitalGeneric FormPhone: 519-663-3071
Fax: 519-663-3073
Fax consult
Dr. Farquhar, Donald1. Internal Medicine
2. Respirology
LHSC – University HospitalGeneric FormPhone: 519-646-6227
Fax: 519-663-3291
Fax consult
Dr. Goldszmidt, Mark1. Internal Medicine
2. Complex Medical Care
LHSC – University HospitalGeneric FormPhone: 519-685-8500 ext 35995
Fax: 519-663-3062
Fax consult
Dr. Gryn, Steven1. Internal Medicine
2. Clinical Pharmacology & Toxicity
LHSC – University HospitalGeneric FormPhone: 519-663-2922
Fax: 519-663-3217
Fax consult
Dr. Hackam, Dan1. Internal Medicine
2. Clinical Pharmacology & Toxicity
LHSC – University HospitalGeneric FormPhone: 519-531-5731
Fax: 519-931-5737
Fax consult
Dr. Huda, Noureen –1. Internal MedicineLHSC – University HospitalGeneric FormPhone: 519-685-8500 ext 33024
Fax: 519-663-2908
Fax consult
Dr. Kim, Richard1. Internal Medicine
2. Clinical Pharmacology & Toxicity
LHSC – University HospitalDr. Kim Personalized Med ReferralPhone: 519-663-3553
Fax: 519-663-3090
Fax consult
Dr. Mrkobrada, Marko1. Internal MedicineLHSC – University HospitalGeneric FormPhone: 519-685-8500 ext 33170
Fax: 519-663-3414
Fax consult
Dr. Myers, Kathryn1. Internal Medicine
2. Hypertension
3. Vascular Risk Reduction
LHSC – University HospitalGeneric FormPhone: 519-646-6142
Fax: 519-663-3291
Fax consult
Dr. Yu, Jeffrey1. Internal MedicineLHSC – University HospitalGeneric FormPhone: 519-663-2958
Fax: 519-663-3062
Fax consult

Victoria Hospital – London Physicians

Victoria Hospital PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Brownscombe, Larry1. Internal MedicineLHSC – Victoria HospitalGeneric FormPhone: 519-685-8166
Fax: 519-685-8166
Fax consult
Dr. Dresser, George1. Internal Medicine
2. Clinical Pharmacology & Toxicology
LHSC – Victoria HospitalGeneric FormPhone: 519-663-3342
Fax: 519-663-3388
Fax consult
Dr. Moore, Mary1. Internal Medicine
2. Opthamology (Ocular Inflammatory Disease)
3. Peri-Operative Medicine
LHSC – Victoria HospitalGeneric FormPhone: 519-667-6676
Fax: 519-472-4614
Fax consult
Dr. Patrick, Larry1. Internal Medicine
2. Cardiology
3. Cardiac Rehab
LHSC – Victoria HospitalGeneric FormPhone: 519-685-8315
Fax: 519-685-8316
Fax consult
Dr. Salim, Hatem1. Internal MedicineLHSC – Victoria HospitalGeneric FormPhone: 519-685-8500 Ext. 58132
Fax: 519-685-8357
Fax consult
Speaks Arabic
Dr. Sun, Dongmei1. Internal Medicine
2. Medical Disorders in Pregnancy
LHSC – Victoria HospitalGeneric FormPhone: 519-685-8500 ext 57034
Fax: 1-888-789-6130
Fax consult
Speaks Mandarin
Dr. Wyllie, Blair1. Internal Medicine
2. Nephrology
LHSC – Victoria HospitalGeneric FormPhone: 519-685-8132
Fax: 519-685-8357
Fax consult
Dr. Zafar, Saira1. Internal MedicineLHSC – Victoria HospitalGeneric FormPhone: 519-685-8500 ext 58132
Fax: 519-685-8357
Fax consult
Speaks Hindi, Punjabi, Urdu

St. Joseph’s Hospital – London Physicians

St. Joseph’s Hospital PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Gilbert, Kenneth1. Internal Medicine
2. Peri-Operative Medicine
St. Joseph’s Healthcare CentreGeneric FormPhone: 519-646-6000 ext 64674
Fax: 1-888-678-3469
Fax consult
Speaks French
Dr. Larocque, Brian1. Internal MedicineSt. Joseph’s Healthcare CentreGeneric FormPhone: 519-646-6100
Fax: 519-646-6064
Fax consult

Community London Physicians

Community London PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Khan, Airudin1. Internal Medicine279 Wharncliffe Rd N, Suite 223
London, ON
N6H 2C2
Generic FormPhone: 519-679-0351
Fax: 519-679-7867
Fax consult
Dr. Leblanc, Herve1. Internal Medicine641 Commissioners Rd E, Suite 105
London, ON
N6G 2T9
Generic FormPhone: 519-686-8585
Fax: 519-686-8580
Fax consult
Dr. Martell, Rafael1. Internal Medicine
2. Cardiology
219 Oxford St W, Suite 102A
London, ON
N6H 1S5
Generic FormPhone: 519-432-3771
Fax: 519-432-3814
Fax consult
Speaks Spanish
Dr. Patel, Paulum1. Internal Medicine
2. Clinical Immunology
Deveron Medical Clinic
#7-1166 Commissioners Road E, London, ON
N5Z4W8
Generic FormPhone: 519-668-6226
Fax: 519-668-7244
Fax consult
Dr. Sanatani, Irina1. Internal Medicine190 Wortley Rd, Suite 205
London, ON
N6C 4Y7
Generic FormPhone: 519-204-6727
Fax: 519-649-5055
Fax consult
Speaks Russian
Dr. Nnaemeka, Ukwuoma1. Internal Medicine
2. Cardio related (SOB/chest pain, afib, heart failure, holtermonitor)
3. Weight Management
4. Geriatrics (polypharmacy, cognitive impairment, geriatric syndromes)
140 Oxford Street East
London ON N6A 5R9
Generic FormFax consult

Stratford Physicians

Stratford PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Barry, Catherine1. Internal Medicine444 Douro St, Suite 107
Stratford, ON
N5A 0E6
Stratford Internal Medicine AssociatesPhone: 519-273-0100
Fax: 519-273-0675
Fax consult
Dr. Caines, Angela1. Internal Medicine
2. Diabetes in Pregnancy
444 Douro St, Suite 107
Stratford, ON
N5A 0E6
Stratford Internal Medicine AssociatesPhone: 519-273-0100
Fax: 519-273-0675
Fax consult
Dr. Dhillon, Yadwinder1. Internal Medicine444 Douro St, Suite 107
Stratford, ON
N5A 0E6
Stratford Internal Medicine AssociatesPhone: 519-273-0100
Fax: 519-273-0675
Fax consult
Speaks Hindi, Punjabi, Russian
Dr. Haffner, Thomas1. Internal Medicine444 Douro St, Suite 107
Stratford, ON
N5A 0E6
Stratford Internal Medicine AssociatesPhone: 519-273-1900
Fax: 519-273-0675
Fax consult
Dr. Kara, Ali1. Internal Medicine444 Douro St, Suite 107
Stratford, ON
N5A 0E6
Stratford Internal Medicine AssociatesPhone: 519-273-1900
Fax: 519-273-0675
Fax consult
Dr. Narayan, Shanil1. Internal Medicine444 Douro St, Suite 107
Stratford, ON
N5A 0E6
Stratford Internal Medicine AssociatesPhone: 519-273-0100
Fax: 519-273-0675
Fax consult
Dr. Peirce, Michael1. Internal Medicine
2. Diabetes in Pregnancy
444 Douro St, Suite 107
Stratford, ON
N5A 0E6
Stratford Internal Medicine AssociatesPhone: 519-273-0100
Fax: 519-273-0675
Fax consult
Dr. Van Oosten, Erik1. Internal Medicine444 Douro St, Suite 107
Stratford, ON
N5A 0E6
Stratford Internal Medicine AssociatesPhone: 519-273-0100
Fax: 519-273-0675
Fax consult
Dr. Nicholson, Janis1. Internal MedicineStratford General HospitalGeneric FormPhone: 519-271-2120
Fax: 519-272-8199
Fax consult
Dr. Tamblyn, Charles1. Internal Medicine236 Ontario St
Stratford, ON
N5A 3H5
Generic FormPhone: 519-273-2681
Fax: 519-273-4533
Fax consult

Strathroy Physicians

Strathroy PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Gomes, David1. Internal MedicineStrathroy Middlesex General HospitalGeneric FormPhone: 519-245-5180
Fax: 519-245-3391
Fax consult
Speaks Portuguese
Dr. Sanders, David1. Internal Medicine
2. Cardiology
Strathroy Middlesex General HospitalGeneric FormPhone: 519-245-4290
Fax: 519-245-4627
Fax consult
Dr. Soliman, Samy1. Internal Medicine
2. Cardiology
Strathroy Middlesex General HospitalGeneric FormPhone: 519-245-5295 ext 5130
Fax: 519-245-4354
Fax consult
Speaks Arabic

St. Thomas Physicians

St. Thomas PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Chehadi, Waleed1. Internal Medicine
2. Cardiology
3. Diabetes
St Thomas Elgin General HospitalGeneric FormPhone: 519-207-9100
Fax: 519-207-9200
Fax consult
Dr. Hawken, Katherine1. Internal MedicineSt Thomas Elgin General HospitalGeneric FormPhone: 519-631-1380
Fax: 519-631-6143
Fax consult
Dr. McIntyre, Kathryn1. Internal MedicineSt Thomas Elgin General HospitalGeneric FormPhone: 519-207-9100
Fax: 519-207-9200
Fax consult
Dr. Sardar, Zahid1. Internal Medicine
2. Cardiology
120 Wellington St
St Thomas, ON
N5R 2R4
Generic FormPhone: 519-633-9200
Fax: 519-633-2391
Fax consult

Woodstock & Ingersoll Physicians

Ingersoll & Woodstock PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Hanoman, Marguerite1. Internal Medicine185 Oxford St
Ingersoll, ON
N5C 2V8
Generic FormPhone: 519-485-5829
Fax: 519-485-1903
Fax consult
Dr. Al-Mane, Faisal1. Internal Medicine
2. Cardiology
300 Main street Unit 1
Woodstock ON
N4S 1T3
Generic FormPhone: 519-421-3323
Fax: 519-421-3933
Fax consult
Dr. Fullerton, Gary1. Internal Medicine
2. Cardiology
437 Norwich Ave
Woodstock, ON
N4S 3W5
Generic Form KMH CardiologyPhone: 519-539-1261
Fax: 519-539-8737
Fax consult

Goderich & Tillsonburg Physicians

Goderich & Tillsonburg PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Fiaani, Majed1. Internal Medicine
2. Cardiology
Alexandra Marine and General HospitalGeneric FormPhone: 519-524-8323 ext 5602
Fax: 519-524-8527
Fax consult
Dr. Abdalla, Mohamed1. Internal MedicineTillsonburg District Memorial HospitalGeneric FormPhone: 519-842-3611
Fax: 519-842-6733
Fax consult
Speaks French and Swahili

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.