Respirology

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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Clinics

ClinicLocationFormContactInformation
St. Joseph Allergy, Asthma, COPD, Respiratory ClinicsSJHC 3rd Floor Zone BAllergy Referral FormPFT Referral FormPhone: 519-646-6000
Asthma: ext: 66128
COPD Ext: 66158
PFT Lab: 61389

Fax Numbers:
Allergy: 519-646-6292
PFT: 519-646-6164
Fax to SJHC
Website
Pulmonary Function Lab
Strathroy Middlesex General Hospital
Strathroy Middlesex General HospitalPulmonary Function Laboratory RequisitionPhone: 519-245-5295 ext. 5440
Fax: 519-246-5919
Fax form

London Physicians

London PhysiciansLocationFormContactInformation
Dr. Dhaliwal, InderdeepLHSC – Victoria HospitalGeneric FormPhone: 519-667-6596
Fax: 519-685-8406
Fax Consult
Dr. Farquhar, DonaldLHSC – University Hospital

St. Joseph’s Hospital
Generic FormPhone: 519-646-6227
Fax: 519-663-3291
Fax Consult
Dr. George, FrederickLHSC – Victoria HospitalGeneric FormPhone: 519-667-6860
Fax: 519-685-8406
Fax Consult
Dr. Kashgari, AliaLHSC – Victoria HospitalGeneric FormPhone: 519-685-8094
Fax: 519-685-8406
Fax Consult
Speaks Arabic
Dr. Lewis, JamesSt. Joseph’s HospitalGeneric FormPhone: 519-646-6288
Fax: 519-646-6404
Fax Consult
Dr. Licskai, ChristopherLHSC – Victoria HospitalGeneric FormPhone: 519-646-6405
Fax: 519-685-8406
Fax Consult
Dr. Mackenzie, Constance 
(Clinical Pharmacology)
St. Joseph’s HospitalGeneric FormPhone: 519-667-6767
Fax: 519-685-8406
Fax Consult
Speaks German
Dr. Mehta, SanjayLHSC – Victoria HospitalGeneric FormPhone: 519-667-6723
Fax: 519-685-8406
Fax Consult
Speaks French & Hindi
Dr. Mura, MarcoLHSC – Victoria HospitalGeneric FormPhone: 519-685-6744
Fax: 519-685-8406
Fax Consult
Speaks Italian
Dr. Povitz, MarcusLHSC – Victoria HospitalGeneric FormPhone: 519-685-8500 x 53085
Fax: 519-685-8406
Fax Consult
Dr. Yamashita, CorySt. Joseph’s HospitalGeneric FormPhone: 519-646-6000 x 65283
Fax: 519-646-6404
Fax Consult

St. Thomas Physicians

St. Thomas PhysiciansLocationFormContactInformation
Dr. Rozanski, CamillaSt. Thomas Elgin General HospitalGeneric FormPhone: 519-631-1380
Fax: 519-631-6143
Fax consult

Pediatric Physicians

Pediatric PhysiciansLocationFormContactInformation
Dr. Lyttle, Brian
(Pediatric Resp)
239 Oxford St. E., London, ON N6A 1V2 lGeneric FormPhone: 519-433-2242
Fax: 519-645-7565
Fax Consult
Dr. Price, April
(Pediatric Resp)
LHSC – Victoria HospitalGeneric FormPhone: 519-685-8500  x 58824
Fax: 519-685-8156
Fax Consult

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