Custom Forms
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Browse all custom forms and eForms in the HFHT Library below
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Good to Know
HNHB Regional Cancer Program – Colposcopy Referral
Ontario Health West CT and MRI Requisition Forms
Custom Forms (New/Updated)
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| Form | Form Categories | Subject | EMR | 1st Page Preview | Form Location | Link | Date Modified | hf:doc_categories | hf:doc_tags |
|---|---|---|---|---|---|---|---|---|---|
| Absolute Medical Centre – Chronic Pain Injections | Referrals | Pain | Telus PS |  | Download | 28 November 2024 | referrals custom-form | pain | |
| Absolute Medical Centre – EMG Request | Referrals | EMG | Telus PS |  | Download | 28 November 2024 | referrals custom-form | emg | |
| Abundance Healthcare | eReferral | Fibromyalgia, Pain | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | fibromyalgia pain | ||
| Alfa-Scan – Xray and Ultrasound | Imaging | Ultrasound, X-Ray | Telus PS |  | Download | 28 November 2024 | imaging custom-form | ultrasound x-ray | |
| Ancaster Cardiology | Referrals | Cardiology | Telus PS |  | Download | 28 November 2024 | referrals custom-form | cardiology | |
| Ancaster X-ray and Ultrasound | eReferral | Ultrasound, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound x-ray | ||
| AVIVA – Allergy Asthma Immunology – Jain/Li | Referrals | Allergy, Asthma, Immunology | Telus PS |  | Download | 28 November 2024 | referrals custom-form | allergy asthma immunology | |
| BIICE – Burlington IUC & Implant Centre of Excellence | Referrals | IUC | Telus PS |  | Download | 28 November 2024 | referrals custom-form | iuc | |
| BLC Medical Specialists – Burlington | eReferral | Respirology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | respirology | ||
| BLC Medical Specialists – Stoney Creek | eReferral | Respirology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | respirology | ||
| BounceBack Ontario | eReferral | Mental Health | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | mental-health | ||
| Brantford General Hospital – Medical Imaging | eReferral | BGH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | bgh | ||
| Brantford Radiology Group – Brant Imaging Clinic | eReferral | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | brg radiology | ||
| Brantford Radiology Group – King George Clinic | eReferral | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | brg radiology | ||
| Brantford Radiology Group – Paris Medical Imaging | eReferral | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | brg radiology | ||
| Brantford Radiology Group – Shellington Imaging Clinic | eReferral | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | brg radiology | ||
| Brantford Radiology Group – St. Paul Imaging Clinic | eReferral | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | brg radiology | ||
| Cardio Study of Hamilton | eReferral | Cardiology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology | ||
| Centre for Sleep Disorders | Referrals | Sleep Medicine | Telus PS |  | Download | 28 November 2024 | referrals custom-form | sleep-medicine | |
| Charlton X-ray | eReferral | X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | x-ray | ||
| Chronic Non-Cancer Pain Management Program | eReferral | Pain | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain | ||
| Chronic-Cough Canada | Referrals | Cough | Telus PS |  | Download | 28 November 2024 | referrals custom-form | cough | |
| Compass CHC Caring for My COPD Pulmonary Rehab Program | eReferral | Compass CHC, Pulmonary | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc pulmonary | ||
| Compass CHC Diabetes Education Program | eReferral | Compass CHC | Ocean eReferral |  | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc | |
| Compass CHC Diabetes Foot Health Program – Brantford | eReferral | Compass CHC, Diabetes | Ocean eReferral |  | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc diabetes | |
| Compass CHC Diabetes Foot Health Program – Burlington | eReferral | Compass CHC, Diabetes | Ocean eReferral |  | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc diabetes | |
| Compass CHC Diabetes Foot Health Program – Hamilton Mountain | eReferral | Compass CHC, Diabetes | Ocean eReferral | | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc diabetes | |
| Compass CHC Diabetes Foot Health Program – Niagara Falls | eReferral | Compass CHC, Diabetes | Ocean eReferral | | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc diabetes | |
| Compass CHC Diabetes Foot Health Program – North Hamilton | eReferral | Compass CHC, Diabetes | Ocean eReferral | | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc diabetes | |
| Compass CHC Diabetes Foot Health Program – St. Catharines | eReferral | Compass CHC, Diabetes | Ocean eReferral | | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc diabetes | |
| Compass CHC Diabetes Foot Health Program – Stoney Creek | eReferral | Compass CHC, Diabetes | Ocean eReferral | | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc diabetes | |
| Compass CHC Diabetes Foot Health Program – Welland | eReferral | Compass CHC, Diabetes | Ocean eReferral | | Ocean Link | 28 November 2024 | ereferral custom-form | compass-chc diabetes | |
| Connect Hearing | eReferral | Hearing | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | hearing | ||
| Crown Point Midwifery | eReferral | Midwifery, Prenatal | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | midwifery prenatal | ||
| Cytology & HPV Testing Requisition – LifeLabs | Lab Requisitions | cytology, HPV, Lifelabs | Telus PS |  | Download | 28 November 2024 | lab-requisitions custom-form | cytology hpv lifelabs | |
| Direct Care Bayshore – Patient Enrolment & Medical Order Form | Referrals | IV Iron | Telus PS |  | Download | 28 November 2024 | referrals custom-form | iv-iron | |
| Dundas Medical Imaging | eReferral | Cardiology, Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology ultrasound | ||
| ELM Medicine | eReferral | Internal Medicine, Pain | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | internal-medicine pain | ||
| GHA Surgical Centre | Endoscopy | eReferral | Endoscopy | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | endoscopy | ||
| GNMI – Hamilton (Nebo Rd) | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| GNMI – Hamilton (Queenston Rd) | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| GNMI – Niagara Falls (McLeod Rd) | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| GNMI – Niagara Falls (Portage Rd) | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| GNMI – St. Catharines (Linwell Rd) | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| GNMI – St. Catharines (Pelham Rd) | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| GNMI – St. Catharines (Welland Ave) | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| GNMI – Stratford | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| GNMI – Welland (Prince Charles Dr) | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| GNMI MRI & CT – Ajax | eReferral | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gnmi | ||
| Halton-Niagara-Southern Ontario Sports and Exercise Medicine | Referrals | Sports Medicine | Telus PS |  | Download | 28 November 2024 | referrals custom-form | sports-medicine | |
| Hamilton Birth Control Clinic | Referrals | Telus PS |  | Download | 28 November 2024 | referrals custom-form | |||
| Hamilton General Hospital – Cardio Metabolic Centre of Excellence | Referrals | HGH | Telus PS |  | Download | 28 November 2024 | referrals custom-form | hgh | |
| Hamilton Health Sciences – Acquired Brain Injury Program | Referrals | Brain, HHS | Telus PS |  | Download | 28 November 2024 | referrals custom-form | brain hhs | |
| Hamilton Health Sciences – Breast MR Consult | Imaging | HHS | Telus PS |  | Download | 28 November 2024 | imaging custom-form | hhs | |
| Hamilton Health Sciences – Cancer Genetics Consultation | Referrals | Cancer Care, HHS | Telus PS |  | Download | 28 November 2024 | referrals custom-form | cancer-care hhs | |
| Hamilton Health Sciences – Cardiac/Coronary CT | Referrals | Cardiology, HHS | Telus PS |  | Download | 28 November 2024 | referrals custom-form | cardiology hhs | |
| Hamilton Health Sciences – McMaster – Valve Clinic | Referrals | HHS, McMaster | Telus PS |  | Download | 28 November 2024 | referrals custom-form | hhs mcmaster | |
| Hamilton Health Sciences – Medical Certificate of Disability | Miscellaneous | Disability, HHS | Telus PS |  | Download | 28 November 2024 | miscellaneous custom-form | disability hhs | |
| Hamilton Health Sciences – Medical Diagnostic Unit Requisition (MDU) | Imaging | HHS, MDU | Telus PS |  | Download | 28 November 2024 | imaging custom-form | hhs mdu | |
| Hamilton Health Sciences – Michael DeGroote Pain Management Program | Referrals | HHS, Pain | Telus PS |  | Download | 28 November 2024 | referrals custom-form | hhs pain | |
| Hamilton Health Sciences – MRI Consultation | Imaging | HHS, MRI | Telus PS |  | Download | 28 November 2024 | imaging custom-form | hhs mri | |
| Hamilton Health Sciences – Request for CT Consultation | Imaging | CT, HHS | Telus PS |  | Download | 28 November 2024 | imaging custom-form | ct hhs | |
| Hamilton Health Sciences – Request for CT Consultation – With Instructions | Imaging | CT, HHS | Telus PS |  | Download | 28 November 2024 | imaging custom-form | ct hhs | |
| Hamilton Health Sciences – Voice Clinic | Referrals | HHS | Telus PS |  | Download | 28 November 2024 | referrals custom-form | hhs | |
| Hamilton Orthopaedic Institute – MSK Injury Clinic | Referrals | MSK, Orthopaedic | Telus PS |  | Download | 28 November 2024 | referrals custom-form | msk orthopaedic | |
| Hamilton Pain Clinic – Chronic Pain | Pain | Pain | Telus PS |  | Download | 28 November 2024 | pain custom-form | pain | |
| Hamilton Primary Care Skin Disorders Clinic | Referrals | Skin Disorders | Telus PS |  | Download | 28 November 2024 | referrals custom-form | skin-disorders | |
| Hamilton Vascular Laboratory | eReferral | Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound | ||
| High Risk Ontario Breast Screening Program (OBSP) – Breast Cancer Genetic Assessment Results Form | Imaging | high risk screening, obsp | Telus PS |  | Download | 28 November 2024 | imaging custom-form | high-risk-screening obsp | |
| High Risk Ontario Breast Screening Program (OBSP) Requisition | Imaging | high risk screening, obsp | Telus PS |  | Download | 28 November 2024 | imaging custom-form | high-risk-screening obsp | |
| HNHB – Request for Ontario Health atHome Services | Referrals | HNHB, OHaH | Telus PS |  | Download | 28 November 2024 | referrals custom-form | hnhb ohah | |
| HNHB – Request for Ontario Health atHome Services – With Instructions | Referrals | HNHB, OHaH | Telus PS |  | Download | 28 November 2024 | referrals custom-form | hnhb ohah | |
| HNHB Behavioural Supports Ontario – Geriatric Services – Central Clinical Intake Referral | Referrals | BSO, CCI, Geriatric | Telus PS |  | Download | 28 November 2024 | referrals custom-form | bso cci geriatric | |
| HNHB Behavioural Supports Ontario – Geriatric Services – Central Clinical Intake Referral- With Instructions | Referrals | BSO, CCI, Geriatric | Telus PS | | Download | 28 November 2024 | referrals custom-form | bso cci geriatric | |
| HNHB Regional Aphasia Programs | Referrals | HNHB | Telus PS |  | Download | 28 November 2024 | referrals custom-form | hnhb | |
| HNHB Regional Cancer Program – Colonoscopy Referral | Referrals | Cancer Care, HNHB | Telus PS |  | Download | 28 November 2024 | referrals custom-form | cancer-care hnhb | |
| JHCC-CIBC-BAC-Breast Referral Form | Referrals | HHS | Telus PS |  | Download | 28 November 2024 | referrals custom-form | hhs | |
| Joseph Brant Hospital – Ambulatory Care | Referrals | JBH | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | jbh | ||
| Joseph Brant Hospital Child and Adolescent Psychiatry Clinic | eReferral | JBH, Psychiatry | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | jbh psychiatry | ||
| Joseph Brant Hospital Diagnostic Imaging | eReferral | JBH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | jbh | ||
| Joseph Brant Hospital Medical Diagnostic Unit | eReferral | JBH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | jbh | ||
| Kitchener-Waterloo Vascular Laboratory | eReferral | Cardiology, Vascular | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology vascular | ||
| KMH Cardiology & MRI Centre – Markham | eReferral | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology kmh | ||
| KMH Cardiology & PET/CT Centre – Mississauga | eReferral | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology kmh | ||
| KMH Cardiology Centre – Burlington | eReferral | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology kmh | ||
| KMH Cardiology Centre – Hamilton | eReferral | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology kmh | ||
| KMH Cardiology Centre – North York | eReferral | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology kmh | ||
| KMH Cardiology Centre – Scarborough | eReferral | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology kmh | ||
| KMH Cardiology Centre – St. Catharines | eReferral | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology kmh | ||
| KMH Cardiology Centre – Toronto | eReferral | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology kmh | ||
| KMH Cardiology Centre – Woodstock | eReferral | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology kmh | ||
| Locke Medical Clinic – Consultation-EMG-NCS | Referrals | EMG, NCS | Telus PS |  | Download | 28 November 2024 | referrals custom-form | emg ncs | |
| Main Ultrasound | eReferral | Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound | ||
| McMaster Children’s Hospital – Pediatric Adolescent Medicine Program | Referrals | McMaster, Pediatric | Telus PS |  | Download | 28 November 2024 | referrals custom-form | mcmaster pediatric | |
| McMaster Children’s Hospital – Pediatric Respirology & Allergy | Referrals | Allergy, McMaster, Pediatric | Telus PS |  | Download | 28 November 2024 | referrals custom-form | allergy mcmaster pediatric | |
| McMaster Children’s Hospital – Pediatric Sleep Medicine | Referrals | McMaster, Pediatric, Sleep Medicine | Telus PS |  | Download | 28 November 2024 | referrals custom-form | mcmaster pediatric sleep-medicine | |
| McMaster Children’s Hospital – Psychiatry Consultation | Referrals | McMaster, Psychiatry | Telus PS |  | Download | 28 November 2024 | referrals custom-form | mcmaster psychiatry | |
| McMaster Spine Surgery – New Consult Requisition Form | Miscellaneous | McMaster | Telus PS |  | Download | 28 November 2024 | miscellaneous custom-form | mcmaster | |
| Medical Certificate for Employment Insurance Care Benefits | Miscellaneous | Telus PS |  | Download | 28 November 2024 | miscellaneous custom-form | |||
| Medisen Cardiology and Internal Medicine | eReferral | Cardiology, Internal Medicine | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology internal-medicine | ||
| MedSleep Niagara Falls | eReferral | Sleep Medicine | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | sleep-medicine | ||
| m-Health Solutions Holter Monitoring | eReferral | ECG | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ecg | ||
| Minerva Comprehensive Pain Management | eReferral | Pain | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain | ||
| Misistry of Health – Patient Enrolment and Consent to Release Personal Health Information | Ministry of Health | Consent, MOH, PHI | Telus PS |  | Download | 28 November 2024 | ministry-of-health custom-form | consent moh phi | |
| Mount Sinai Hospital – Joint Department of Medical Imaging (JDMI) | eReferral | Bone, CT, Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | bone ct ultrasound | ||
| NEJAC – Rapid Access Clinic | Referrals | Telus PS |  | Download | 28 November 2024 | referrals custom-form | |||
| Niagara Health Diagnostic Imaging | eReferral | Ultrasound, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound x-ray | ||
| North Bay cardiology | Referrals | Cardiology | Telus PS |  | Download | 28 November 2024 | referrals custom-form | cardiology | |
| Oakville North Endoscopy | Referrals | Endoscopy | Telus PS |  | Download | 28 November 2024 | referrals custom-form | endoscopy | |
| Ontario Breastfeeding Clinic (OBC) – Physician Group Referral | Referrals | OBC | Telus PS |  | Download | 28 November 2024 | referrals custom-form | obc | |
| Ontario Health atHome – HNHB First Dose IV Risk Assesment | Referrals | OHaH | Telus PS |  | Download | 28 November 2024 | referrals custom-form | ohah | |
| Ontario Health atHome Waterloo Wellington | eReferral | OHaH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ohah | ||
| Ontario Structured Psychotherapy West | eReferral | OSPW | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ospw | ||
| Pain Care Clinic – Hamilton | eReferral | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain pcc | ||
| Pain Care Clinic – Kitchener | eReferral | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain pcc | ||
| Pain Care Clinic – Mississauga | eReferral | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain pcc | ||
| Pain Care Clinic – Niagara Falls | eReferral | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain pcc | ||
| Pain Care Clinic – Orangeville | eReferral | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain pcc | ||
| Pain Care Clinic – St. Catherines | eReferral | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain pcc | ||
| Pain Care Clinic – Welland | eReferral | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain pcc | ||
| Pain Care Clinic – Windsor | eReferral | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain pcc | ||
| Pain Care Clinic – Windsor County | eReferral | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain pcc | ||
| Possibilities Clinic | eReferral | ADHD, Mental Health | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | adhd mental-health | ||
| Precision Care Centre | eReferral | Pain, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | pain radiology | ||
| Provis Endoscopy Services – Ottawa East | eReferral | Endoscopy | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | endoscopy | ||
| Public Health Ontario – Reference Bacteriology Requisition | Lab Requisitions | bacteriology, PHO, public health | Telus PS |  | Download | 28 November 2024 | lab-requisitions custom-form | bacteriology pho public-health | |
| Public Health Ontario – Report of Adverse Event Following Immunization – 2024 | Miscellaneous | PHO, public health | Telus PS |  | Download | 28 November 2024 | miscellaneous custom-form | pho public-health | |
| Public Health Services Hamilton – Chlamydia Surveillance Package CICW | Lab Requisitions | Chlamydia, PHO, public health | Telus PS |  | Download | 28 November 2024 | lab-requisitions custom-form | chlamydia pho public-health | |
| Public Health Services Hamilton – Gonorrhea Surveillance Package CICW | Lab Requisitions | Gonorrhea, PHO, public health | Telus PS |  | Download | 28 November 2024 | lab-requisitions custom-form | gonorrhea pho public-health | |
| Public Health Services Hamilton – Positive TB Skin Test (TST) | Lab Requisitions | Skin, TB | Telus PS |  | Download | 28 November 2024 | lab-requisitions custom-form | skin tb | |
| Restore Hyperbaric Oxygen and Medical Centre | eReferral | Oxygen | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | oxygen | ||
| Southwest Ultrasound | eReferral | Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound | ||
| St. Joseph’s Healthcare Hamilton – Connect Mental Health and Addiction Outpatient Programs | eReferral | addiction, Mental Health, SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | addiction mental-health sjhh | ||
| St. Joseph’s Healthcare Hamilton – Diagnostic Imaging – Charlton Campus | eReferral | SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | sjhh | ||
| St. Joseph’s Healthcare Hamilton – Esophageal Diagnostic Assessment Program | eReferral | SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | sjhh | ||
| St. Joseph’s Healthcare Hamilton – IV Iron Replacement Order Set | Miscellaneous | IV Iron, SJH | Telus PS |  | Download | 28 November 2024 | miscellaneous custom-form | iv-iron sjh | |
| St. Joseph’s Healthcare Hamilton – Obstetrics & Gynecology 2 Fontbonne | eReferral | Gynecology, Obstetrics, SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gynecology obstetrics sjhh | ||
| St. Joseph’s Healthcare Hamilton – Outpatient Nephrology | eReferral | Nephrology, SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | nephrology sjhh | ||
| St. Joseph’s Healthcare London – ROTH McFarlane Hand and Upper Limb Centre | Referrals | SJH | Telus PS |  | Download | 28 November 2024 | referrals custom-form | sjh | |
| Specialized Ultrasound in Gynecology & Obstetrics – SUGO | eReferral | Gynecology, Obstetrics, Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | gynecology obstetrics ultrasound | ||
| The Minor Surgery Center | Referrals | TMSC | Telus PS |  | Download | 28 November 2024 | referrals custom-form | tmsc | |
| UHN – Centre for Mental Health | Referrals | Mental Health | Telus PS |  | Download | 28 November 2024 | referrals custom-form | mental-health | |
| UltraScan Medical Diagnostic Imaging | eReferral | Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound | ||
| WELL Health Diagnostic Centres – Brantford – Cardiology | eReferral | Cardiology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology | ||
| WELL Health Diagnostic Centres – Mississauga – Cardiology | eReferral | Cardiology | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | cardiology | ||
| Wentworth-Halton X-Ray and Ultrasound Inc. – 15 Mountain Ave | eReferral | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound wh x-ray | ||
| Wentworth-Halton X-Ray and Ultrasound Inc. – 325 Winterberry Drive | eReferral | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound wh x-ray | ||
| Wentworth-Halton X-Ray and Ultrasound Inc. – Medical Arts | eReferral | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound wh x-ray | ||
| Wentworth-Halton X-Ray and Ultrasound Inc. – Waterdown | eReferral | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound wh x-ray | ||
| Wentworth-Halton X-Ray and Ultrasound Inc. – Westmount | eReferral | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | ereferral custom-form | ultrasound wh x-ray | ||
| Women’s College Hospital – Mental Health | Referrals | Mental Health, WCH | Telus PS |  | Download | 28 November 2024 | referrals custom-form | mental-health wch | |
| St. Joseph’s Healthcare Hamilton – Diagnostic Imaging – West 5th Campus | eReferral | SJHH | Ocean eReferral | Ocean Link | 16 December 2024 | ereferral custom-form | sjhh | ||
| St. Joseph’s Healthcare Hamilton – Diagnostic Imaging – King Campus | eReferral | SJHH | Ocean eReferral | Ocean Link | 16 December 2024 | ereferral custom-form | sjhh | ||
| Dynacare Harmony Prenatal Test | Lab Requisitions | Dynacare, Prenatal | Telus PS |  | Download | 16 December 2024 | lab-requisitions custom-form | dynacare prenatal | |
| CRA Disability Tax Credit Certificate 2023 | Miscellaneous | Disability | Telus PS |  | Download | 16 December 2024 | miscellaneous custom-form | disability | |
| 2019 Lab Requisition | Lab Requisitions | MOH | Telus PS |  | Download | 16 December 2024 | lab-requisitions custom-form | moh | |
| Hamilton Health Sciences – MUMC – Adult Outpatient Swallowing Form | Referrals | HHS, MUMC | Telus PS |  | Download | 16 December 2024 | referrals custom-form | hhs mumc | |
| Organon Aspire – NEXPLANON – Scheduling Support Appointment Form | Miscellaneous | NEXPLANON | Telus PS |  | Download | 16 December 2024 | miscellaneous custom-form | nexplanon | |
| Ontario Health – Lung Screening Program – SJH | Referrals | Lung, OH | Telus PS |  | Download | 16 December 2024 | referrals custom-form | lung oh | |
| Ontario Health – Lung Screening Program – SJH – With Instructions | Referrals | Lung, OH | Telus PS | | Download | 16 December 2024 | referrals custom-form | lung oh | |
| McMaster Children’s Hospital – Pediatric Echocardiogram | Imaging | McMaster, Pediatric | Telus PS |  | Download | 13 February 2025 | imaging custom-form | mcmaster pediatric | |
| Beamsville Diagnostic Imaging | Imaging | imaging | Telus PS |  | Download | 13 February 2025 | imaging custom-form | imaging | |
| Public Health Ontario – HCV/HBV Viral Load, Genotyping, and Drug Resistance | Lab Requisitions | PHO, public health | Telus PS |  | Download | 13 February 2025 | lab-requisitions custom-form | pho public-health | |
| Public Health Ontario – HCV/HBV Viral Load, Genotyping, and Drug Resistance – With Instructions | Lab Requisitions | PHO, public health | Telus PS | | Download | 13 February 2025 | lab-requisitions custom-form | pho public-health | |
| Medical Assistance in Dying – MAiD – Clinician Aid C | Ministry of Health | MAiD, MOH | Telus PS |  | Download | 13 February 2025 | ministry-of-health custom-form | maid moh | |
| Ontario Health atHome – Letter of Understanding for the Pronouncement of Death | Miscellaneous | OH | Telus PS |  | Download | 13 February 2025 | miscellaneous custom-form | oh | |
| Ministry of Transportation – Medical Condition Report | Miscellaneous | MOT | Telus PS |  | Download | 13 February 2025 | miscellaneous custom-form | mot | |
| Public Health Services Hamilton – RSV Vaccine Order Form | Miscellaneous | public health, Vaccine | Telus PS |  | Download | 13 February 2025 | miscellaneous custom-form | public-health vaccine | |
| Musculoskeletal – Central Intake & Assessment Centre – MSK CIAC – Low Back Pain Assessment | Referrals | MSK | Telus PS |  | Download | 13 February 2025 | referrals custom-form | msk | |
| McMaster Children’s Hospital – MUMC – 2G Pediatric Ambulatory Clinics | Referrals | McMaster, Pediatric | Telus PS |  | Download | 13 February 2025 | referrals custom-form | mcmaster pediatric | |
| St. Peter’s Hospital – Centre for Healthy Aging – Long Term Care Home | Referrals | HHS | Telus PS |  | Download | 13 February 2025 | referrals custom-form | hhs | |
| Hamilton Health Sciences – MUMC – 2F Prenatal Diagnosis Clinic | Referrals | HHS, MUMC, Prenatal | Telus PS |  | Download | 13 February 2025 | referrals custom-form | hhs mumc prenatal | |
| Rejuvenation Dermatology Oakville – RapidDerm Clinic | Referrals | Dermatology | Telus PS |  | Download | 13 February 2025 | referrals custom-form | dermatology | |
| South Coast Physiotherapy | Referrals | Physiotherapy | Telus PS |  | Download | 13 February 2025 | referrals custom-form | physiotherapy | |
| Hamilton Health Sciences – Consent to Disclose Personal Health Information | Miscellaneous | HHS | Telus PS |  | Download | 13 February 2025 | miscellaneous custom-form | hhs | |
| Ontario Health – HPV – Cytology Test for Cervical Screening | Lab Requisitions, Ministry of Health | CCO, cytology, HPV, OH | Telus PS |  | Download | 19 February 2025 | lab-requisitions ministry-of-health custom-form | cco cytology hpv oh | |
| Ontario Health – HPV – Cytology Test for Cervical Screening – OSCAR | Lab Requisitions, Ministry of Health | CCO, HPV, OH, OSCAR | OSCAR | | Download | 19 February 2025 | lab-requisitions ministry-of-health custom-form | cco hpv oh oscar | |
| Haldimand Tongue Tie Assessment and Breastfeeding Support Clinic | Referrals | Midwifery | Telus PS |  | Download | 24 February 2025 | referrals custom-form | midwifery | |
| Haldimand Interim Perinatal Primary Care Clinic | Referrals | Perinatal | Telus PS |  | Download | 24 February 2025 | referrals custom-form | perinatal | |
| Health and Social Services – HNHSS – TB – Immigration Medical Surveillance | Referrals | HNHSS, TB | Telus PS |  | Download | 24 February 2025 | referrals custom-form | hnhss tb | |
| Health and Social Services – HNHSS – STI Reporting Form – Chlamydia-Gonorrhea | Referrals | Chlamydia, Gonorrhea, HNHSS, STI | Telus PS |  | Download | 24 February 2025 | referrals custom-form | chlamydia gonorrhea hnhss sti | |
| Ontario Health atHome – SouthWest – Request for Assessment | Referrals | OHaH | Telus PS |  | Download | 24 February 2025 | referrals custom-form | ohah | |
| West Lincoln Memorial Hospital – Breast Imaging Requisition | Referrals | WLMH | Telus PS |  | Download | 24 February 2025 | referrals custom-form | wlmh | |
| Hamilton Health Sciences – Special Immunology Services (SIS) Clinic – Adult Form | Referrals | HHS, Immunology | Telus PS |  | Download | 24 February 2025 | referrals custom-form | hhs immunology | |
| Hamilton Health Sciences – Special Immunology Services (SIS) Clinic – Pediatric Form | Referrals | HHS, Immunology, Pediatric | Telus PS |  | Download | 24 February 2025 | referrals custom-form | hhs immunology pediatric | |
| AVIVA – Allergy, Asthma and Clinical Immunology – Pratt | Referrals | Allergy, Asthma, AVIVA, Immunology | Telus PS |  | Download | 26 February 2025 | referrals custom-form | allergy asthma aviva immunology | |
| Ontario Health – HPV – Cytology Test – Colposcopy follow-up of Cervical Screening | Lab Requisitions, Ministry of Health | CCO, Colposcopy, cytology, HPV, OH | Telus PS |  | Download | 26 February 2025 | lab-requisitions ministry-of-health custom-form | cco colposcopy cytology hpv oh | |
| St. Joseph’s Healthcare Hamilton – Cardiology Diagnostics | Imaging | Cardiology, SJH | Telus PS |  | Download | 27 March 2025 | imaging custom-form | cardiology sjh | |
| SJH – FIRH – Firestone Institute for Respiratory Health – Laboratory Requisition | Lab Requisitions | firestone, FIRH, SJH | Telus PS |  | Download | 27 March 2025 | lab-requisitions custom-form | firestone firh sjh | |
| West Plains Medical – Pediatric Form | Referrals | Pediatric | Telus PS |  | Download | 17 April 2025 | referrals custom-form | pediatric | |
| Banyan – Grocer-Ease – Info Form | Referrals | Senior | Telus PS |  | Download | 17 April 2025 | referrals custom-form | senior | |
| Hamilton Urban Core Community Health Centre – Refugee Transition Clinic | Referrals | HUCCHC | Telus PS |  | Download | 17 April 2025 | referrals custom-form | hucchc | |
| HNHB LHIN – Diabetes Education Program | Diabetes, Referrals | Diabetes | Telus PS |  | Download | 17 April 2025 | diabetes referrals custom-form | diabetes | |
| NeuPath – Physician Referral Form | Referrals | Pain, Spine | Telus PS |  | Download | 17 April 2025 | referrals custom-form | pain spine | |
| McMaster Children’s Hospital – Paediatric Ophthalmology and Adult Strabismus | Referrals | McMaster, Pediatric | Telus PS |  | Download | 17 April 2025 | referrals custom-form | mcmaster pediatric | |
| Hamilton Foot Care – Bess | Referrals | Foot Care | Telus PS |  | Download | 17 April 2025 | referrals custom-form | foot-care | |
| McMaster – Gastroenterology | Referrals | Gastroenterology, McMaster, MUMC | Telus PS |  | Download | 17 April 2025 | referrals custom-form | gastroenterology mcmaster mumc | |
| Solos Medical – Pain Clinic Physician Referral | Pain, Referrals | Pain | Telus PS |  | Download | 17 April 2025 | pain referrals custom-form | pain | |
| Ontario Health atHome – Hamilton Palliative Care Outreach Team | Referrals | OHaH, Palliative Care | Telus PS |  | Download | 17 April 2025 | referrals custom-form | ohah palliative-care | |
| Ontario Health atHome – Hamilton Palliative Care Outreach Team – With Instructions | Referrals | OHaH, Palliative Care | Telus PS | | Download | 17 April 2025 | referrals custom-form | ohah palliative-care | |
| Public Health Services Hamilton – Fare Assist Discount Application | Miscellaneous | public health | Telus PS |  | Download | 17 April 2025 | miscellaneous custom-form | public-health | |
| Ontario Health atHome – Request for Services | Referrals | OHaH | Telus PS |  | Download | 17 April 2025 | referrals custom-form | ohah | |
| Canmax Medical Imaging | Imaging | MRI, X-Ray | Telus PS |  | Download | 17 April 2025 | imaging custom-form | mri x-ray | |
| Hamilton Diagnostic Imaging | Imaging | Ultrasound, X-Ray | Telus PS |  | Download | 17 April 2025 | imaging custom-form | ultrasound x-ray | |
| Hamilton Regional Lab – Cancer Genetics – Hematologic Neoplasia | Lab Requisitions | Cancer Care | Telus PS |  | Download | 17 April 2025 | lab-requisitions custom-form | cancer-care | |
| Hamilton Regional Lab – Cancer Genetics – Molecular Diagnostics | Lab Requisitions | Cancer Care | Telus PS |  | Download | 17 April 2025 | lab-requisitions custom-form | cancer-care | |
| Hamilton Regional Lab – Cancer Genetics – Cytogenetic Testing | Lab Requisitions | Cancer Care | Telus PS |  | Download | 17 April 2025 | lab-requisitions custom-form | cancer-care | |
| InflaFlex – HairGian – Molluscum – Maxym | Referrals | Pharmacy | Telus PS |  | Download | 17 April 2025 | referrals custom-form | pharmacy | |
| McMaster Children’s Hospital – CYMHP – Pediatric Mental Health Consult | Mental Health, Referrals | McMaster, Mental Health, Pediatric | Telus PS |  | Download | 17 April 2025 | mental-health referrals custom-form | mcmaster mental-health pediatric | |
| Sleep Disorders Clinic- Cambridge Memorial Hospital | eReferral | Sleep Disorders | Ocean eReferral | Ocean Link | 17 April 2025 | ereferral custom-form | sleep-disorders | ||
| Sleep Disorders Clinic – Hamilton | eReferral | Sleep Disorders | Ocean eReferral | Ocean Link | 17 April 2025 | ereferral custom-form | sleep-disorders | ||
| Sleep Disorders Clinic- St. Catharines | eReferral | Sleep Disorders | Ocean eReferral | Ocean Link | 17 April 2025 | ereferral custom-form | sleep-disorders | ||
| Hamilton Family Health Team – (Locations of Groups and Workshops vary) | eReferral | HFHT | Ocean eReferral | Ocean Link | 17 April 2025 | ereferral custom-form | hfht | ||
| Hamilton Family Health Team – MAiD Community Outreach Team | eReferral | HFHT, MAiD | Ocean eReferral | Ocean Link | 17 April 2025 | ereferral custom-form | hfht maid | ||
| PEDIATRIC URGENT CARE – OAKVILLE | eReferral | Pediatric | Ocean eReferral | Ocean Link | 17 April 2025 | ereferral custom-form | pediatric | ||
| PEDIATRIC URGENT CARE – MISSISSAUGA | eReferral | Pediatric | Ocean eReferral | Ocean Link | 17 April 2025 | ereferral custom-form | pediatric | ||
| PEDIATRIC URGENT CARE – TORONTO | eReferral | Pediatric | Ocean eReferral | Ocean Link | 17 April 2025 | ereferral custom-form | pediatric | ||
| Rourke Guide Package – One Visit – May-18-2024 | Child Health | RBR | Telus PS |  | Download | 14 May 2025 | child-health custom-form | rbr | |
| Seashell Medical Clinic | eReferral | Pediatric | Ocean eReferral | Ocean Link | 4 June 2025 | ereferral custom-form | pediatric | ||
| RVH – Renfrew Victoria Hospital – Medical Imaging | eReferral | CT, Ultrasound | Ocean eReferral | Ocean Link | 4 June 2025 | ereferral custom-form | ct ultrasound | ||
| Cambridge Cardiac Care Centre | eReferral | Cardiology | Ocean eReferral | Ocean Link | 4 June 2025 | ereferral custom-form | cardiology | ||
| STL Diagnostic Imaging – Mobile X-Ray/Ultrasound | Imaging | Ultrasound, X-Ray | Telus PS |  | Download | 4 June 2025 | imaging custom-form | ultrasound x-ray | |
| STL Diagnostic Imaging – Mobile X-Ray/Ultrasound – With Instructions | Imaging | Ultrasound, X-Ray | Telus PS | | Download | 4 June 2025 | imaging custom-form | ultrasound x-ray | |
| GTA – General Medical Imaging | Imaging | Ultrasound, X-Ray | Telus PS |  | Download | 4 June 2025 | imaging custom-form | ultrasound x-ray | |
| Application for Special Diet Allowance – ODSP | Miscellaneous | ODSP | Telus PS |  | Download | 4 June 2025 | miscellaneous custom-form | odsp | |
| Application for Special Diet Allowance – ODSP – With Instructions | Miscellaneous | ODSP | Telus PS | | Download | 4 June 2025 | miscellaneous custom-form | odsp | |
| Norfolk General Hospital – Pulmonary Function Requisition | Referrals | NGH, Pulmonary | Telus PS |  | Download | 4 June 2025 | referrals custom-form | ngh pulmonary | |
| Internal Medicine Consultation – Chaudhry | Referrals | Internal Medicine, Pulmonary | Telus PS |  | Download | 4 June 2025 | referrals custom-form | internal-medicine pulmonary | |
| Hamilton Orthopaedic Institute – Sosaem | Referrals | Orthopaedic, Sports Medicine | Telus PS |  | Download | 4 June 2025 | referrals custom-form | orthopaedic sports-medicine | |
| Sentry Health – Consultation – Ali | Referrals | Internal Medicine | Telus PS |  | Download | 4 June 2025 | referrals custom-form | internal-medicine | |
| Hamilton Health Sciences – Integrated Adult Concussion Clinic | Referrals | Concussion | Telus PS |  | Download | 4 June 2025 | referrals custom-form | concussion | |
| Afiya Spine & Pain Institute | Referrals | Pain, Spine, Sports Medicine | Telus PS |  | Download | 4 June 2025 | referrals custom-form | pain spine sports-medicine | |
| Trillium Spine Center | Referrals | Pain, Spine | Telus PS |  | Download | 4 June 2025 | referrals custom-form | pain spine | |
| Request for Spine Consultation – Cenic | Referrals | Spine | Telus PS |  | Download | 4 June 2025 | referrals custom-form | spine | |
| Hamilton Community Paramedic Program | Referrals | Paramedicine | Telus PS |  | Download | 4 June 2025 | referrals custom-form | paramedicine | |
| Joint+ Clinic | Referrals | Orthopedic, Sports Medicine | Telus PS |  | Download | 4 June 2025 | referrals custom-form | orthopedic sports-medicine | |
| Women’s College Hospital – Environmental Health Clinic – EHC | Referrals | WCH | Telus PS |  | Download | 4 June 2025 | referrals custom-form | wch | |
| Absolute Medical Centre – Pediatric Group | Referrals | AMC, Pediatric | Telus PS |  | Download | 4 June 2025 | referrals custom-form | amc pediatric | |
| Absolute Medical Centre – Pediatric Group – With Instructions | Referrals | AMC, Pediatric | Telus PS | | Download | 4 June 2025 | referrals custom-form | amc pediatric | |
| Hamilton Health Sciences – RJCHC – Audiology | Referrals | HHS | Telus PS |  | Download | 4 June 2025 | referrals custom-form | hhs | |
| Ontario Health – Lung Screening Program | Referrals | Lung, OH | Telus PS |  | Download | 4 June 2025 | referrals custom-form | lung oh | |
| Ontario Health – Lung Screening Program – With Info | Referrals | Lung, OH | Telus PS | | Download | 4 June 2025 | referrals custom-form | lung oh | |
| Compass Community Health – Gender Affirming Clinic – OSCAR | Referrals | CCH, OSCAR | OSCAR |  | Download | 9 July 2025 | referrals custom-form | cch oscar | |
| Compass Community Health – Gender Affirming Clinic | Referrals | CCH | Telus PS | | Download | 9 July 2025 | referrals custom-form | cch | |
| ITS Hamilton – Interpretation Request Form – OSCAR | Miscellaneous | Interpretation, ITS, OSCAR, Translation | OSCAR |  | Download | 1 August 2025 | miscellaneous custom-form | interpretation its oscar translation | |
| ITS Hamilton – Interpretation Request FAQs | Miscellaneous | Interpretation, ITS, Translation |  | Download | 1 August 2025 | miscellaneous custom-form | interpretation its translation | ||
| Limeworth Xray and Ultrasound – With Instructions | Imaging | Ultrasound, x, X-Ray | Telus PS |  | Download | 6 August 2025 | imaging custom-form | ultrasound x x-ray | |
| Limeworth Xray and Ultrasound | Imaging | Ultrasound, X-Ray | Telus PS | | Download | 6 August 2025 | imaging custom-form | ultrasound x-ray | |
| Haldimand War Memorial Hospital – Request for Diagnostic Imaging | Imaging | HWMH | Telus PS |  | Download | 6 August 2025 | imaging custom-form | hwmh | |
| West Haldimand General Hospital – Diagnostic Imaging | Imaging | Haldimand, WHGH | Telus PS |  | Download | 6 August 2025 | imaging custom-form | haldimand whgh | |
| Hamilton Family Health Team – MaiD – Waver Form | Miscellaneous | HFHT | Telus PS |  | Download | 6 August 2025 | miscellaneous custom-form | hfht | |
| Hamilton Family Health Team – MaiD – Confirmation of Consent | Miscellaneous | HFHT | Telus PS |  | Download | 6 August 2025 | miscellaneous custom-form | hfht | |
| Hamilton Family Health Team – MaiD – Pharmasave-Standard Prescription | Miscellaneous | HFHT | Telus PS |  | Download | 6 August 2025 | miscellaneous custom-form | hfht | |
| Hamilton Family Health Team – Pelvic Health Screening | Miscellaneous | HFHT | Telus PS |  | Download | 6 August 2025 | miscellaneous custom-form | hfht | |
| Premium Cardiac Centre Hamilton | Referrals | cardiac | Telus PS |  | Download | 6 August 2025 | referrals custom-form | cardiac | |
| Heart and Health Clinic – Rheumatology | Referrals | Rheumatology | Telus PS |  | Download | 6 August 2025 | referrals custom-form | rheumatology | |
| Heart and Health Clinic – Gastroenterology | Referrals | Gastroenterology | Telus PS |  | Download | 6 August 2025 | referrals custom-form | gastroenterology | |
| Heart and Health Clinic – Cardiology – Internal Medicine | Referrals | Cardiology, Internal Medicine | Telus PS |  | Download | 6 August 2025 | referrals custom-form | cardiology internal-medicine | |
| Seashell Medical – Psychiatry – Munshi | Referrals | Psychiatry | Telus PS |  | Download | 6 August 2025 | referrals custom-form | psychiatry | |
| NiagaraHealth – Adult Outpatient Mental Health and Addictions | Referrals | Addictions, Mental Health | Telus PS |  | Download | 6 August 2025 | referrals custom-form | addictions mental-health | |
| Hamilton Pediatrics | Referrals | Pediatric | Telus PS |  | Download | 6 August 2025 | referrals custom-form | pediatric | |
| Hear Right Canada – Waterdown | Referrals | Hearing | Telus PS |  | Download | 6 August 2025 | referrals custom-form | hearing | |
| Hamilton Health Sciences – Autism Spectrum Disorders | Referrals | Autism, HHS, McMaster | Telus PS |  | Download | 6 August 2025 | referrals custom-form | autism hhs mcmaster | |
| Pediatrics Rapid Access Clinic | Referrals | Pediatric | Telus PS |  | Download | 6 August 2025 | referrals custom-form | pediatric | |
| ITS Hamilton – Interpretation Request Form | Miscellaneous | Interpretation, ITS, Translation | Telus PS | Download | 7 August 2025 | miscellaneous custom-form | interpretation its translation | ||
| Hamilton Ultrasound Diagnostic Services – HUDS | eReferral | HUDS, Ultrasound | Ocean eReferral | Ocean Link | 7 August 2025 | ereferral custom-form | huds ultrasound | ||
| Ontario Health West – Outpatient MRI Requisition Form | Imaging | MRI, OH, Outpatient | Telus PS |  | Download | 20 August 2025 | imaging custom-form | mri oh outpatient | |
| Ontario Health West – Outpatient CT Requisition Form | Imaging | CT, OH, Outpatient | Telus PS |  | Download | 20 August 2025 | imaging custom-form | ct oh outpatient | |
| McMaster University – Central Triage Rheumatology | Referrals | McMaster, Rheumatology | Telus PS |  | Download | 21 August 2025 | referrals custom-form | mcmaster rheumatology | |
| Ontario Health West – Outpatient CT Requisition Form – OSCAR | Imaging | CT, OH, Ontario Health, OSCAR, Outpatient | OSCAR |  | Download | 22 August 2025 | imaging custom-form | ct oh ontario-health oscar outpatient | |
| Ontario Health West – Outpatient MRI Requisition Form – OSCAR | Imaging | MRI, OH, Ontario Health, OSCAR, Outpatient | OSCAR |  | Download | 22 August 2025 | imaging custom-form | mri oh ontario-health oscar outpatient | |
| LifeLabs Genetics – Panorama – Funded by MOH | Lab Requisitions | Lifelabs, Prenatal | Telus PS |  | Download | 9 October 2025 | lab-requisitions custom-form | lifelabs prenatal | |
| HNHB LHIN – Request for MRI Consultation | Imaging | HNHB, MRI | Telus PS |  | Download | 9 October 2025 | imaging custom-form | hnhb mri | |
| MUMC – 3F Pediatric Ambulatory Clinics | Referrals | McMaster, MUMC, Pediatric | Telus PS |  | Download | 9 October 2025 | referrals custom-form | mcmaster mumc pediatric | |
| St. Joseph’s Healthcare Hamilton – Sleep Disorders Assessment | Referrals | SJH, Sleep Disorders | Telus PS |  | Download | 9 October 2025 | referrals custom-form | sjh sleep-disorders | |
| One Vascular Requisition | Imaging | Vascular | Telus PS |  | Download | 9 October 2025 | imaging custom-form | vascular | |
| Ontario Health atHome – Health Assessment | Ministry of Health | OHaH | Telus PS |  | Download | 9 October 2025 | ministry-of-health custom-form | ohah | |
| Public Health Services Hamilton – STI Medication Order Form | Miscellaneous | public health, STI | Telus PS |  | Download | 9 October 2025 | miscellaneous custom-form | public-health sti | |
| UHN – Goodhope Ehlers-Danlos Syndrome (EDS) Program | Referrals | EDS, UHN | Telus PS |  | Download | 9 October 2025 | referrals custom-form | eds uhn | |
| Application for Accessible Parking Permit | Miscellaneous | APP | Telus PS |  | Download | 9 October 2025 | miscellaneous custom-form | app | |
| Autism Spectrum Quotient – AQ10 | Miscellaneous | Autism | Telus PS |  | Download | 9 October 2025 | miscellaneous custom-form | autism | |
| Charlton Centre for Specialized Treatment | Referrals | Charlton | Telus PS |  | Download | 9 October 2025 | referrals custom-form | charlton | |
| Hamilton Health Sciences – MGD – MUMC – Pain Clinic | Pain, Referrals | HHS, Pain | Telus PS |  | Download | 9 October 2025 | pain referrals custom-form | hhs pain | |
| LifeLabs – Non-Gynecologic Cytology | Lab Requisitions | cytology, Lifelabs | Telus PS |  | Download | 9 October 2025 | lab-requisitions custom-form | cytology lifelabs | |
| Locke Medical Clinic – Gynecology Consultation – Tina Gai | Referrals | Gynecology | Telus PS |  | Download | 9 October 2025 | referrals custom-form | gynecology | |
| McMaster Children’s Hospital – Pediatric Gastroenterology – FAST | Referrals | Gastroenterology, McMaster | Telus PS |  | Download | 9 October 2025 | referrals custom-form | gastroenterology mcmaster | |
| Public Health Services Hamilton – Lyme Disease Surveillance Package | Miscellaneous | Lyme, public health | Telus PS |  | Download | 9 October 2025 | miscellaneous custom-form | lyme public-health | |
| Ritvo Autism-Asperger’s Diagnostic Scale – Revised – (RAADS-R) | Miscellaneous | Autism | Telus PS |  | Download | 9 October 2025 | miscellaneous custom-form | autism | |
| St. Joseph’s Healthcare Hamilton – Chronic Pain Clinic – Knee Radiofrequency Study | Referrals | Knee, Pain, SJHH | Telus PS |  | Download | 9 October 2025 | referrals custom-form | knee pain sjhh | |
| HNHB Regional Cancer Program – Colposcopy Referral | Referrals | Cancer Care, Colposcopy, HNHB | Telus PS |  | Download | 24 November 2025 | referrals custom-form | cancer-care colposcopy hnhb | |
| HNHB Regional Cancer Program – Colposcopy Referral – OSCAR | Referrals | Cancer Care, Colposcopy, HNHB, OSCAR | OSCAR | | Download | 24 November 2025 | referrals custom-form | cancer-care colposcopy hnhb oscar | |
| Brant Community Healthcare System – Outpatient Swallowing Clinic | Referrals | BCHS, BGH | Telus PS |  | Download | 4 December 2025 | referrals custom-form | bchs bgh | |
| NeuPath Centre for Pain & Spine – Hamilton | eReferral | Pain, Spine | Ocean eReferral | Ocean Link | 4 December 2025 | ereferral custom-form | pain spine | ||
| Hamilton Health Sciences – Dyslipidemia Management – Prevention and Triage | Referrals | HHS | Telus PS |  | Download | 4 December 2025 | referrals custom-form | hhs | |
| Heart and Health Cardiology Clinic (Stoney Creek) | eReferral | Cardiology, Gastroenterology | Ocean eReferral | Ocean Link | 4 December 2025 | ereferral custom-form | cardiology gastroenterology | ||
| Heart and Health Cardiology Clinic (Hamilton) | eReferral | Cardiology, Gastroenterology | Ocean eReferral | Ocean Link | 4 December 2025 | ereferral custom-form | cardiology gastroenterology | ||
| Hamilton Health Sciences – MGD – Chronic Headache Clinic | Referrals | HHS, MUMC | Telus PS |  | Download | 4 December 2025 | referrals custom-form | hhs mumc | |
| Hamilton Regional Lab – Familial Hypercholesterolemia Investigation | Lab Requisitions | FH, genetics | Telus PS |  | Download | 4 December 2025 | lab-requisitions custom-form | fh genetics | |
| Locke Medical Clinic – Diagnostic Imaging | Referrals | Cardiology | Telus PS |  | Download | 4 December 2025 | referrals custom-form | cardiology | |
| Locke Medical Clinic – Internal Medicine | Referrals | Internal Medicine | Telus PS |  | Download | 4 December 2025 | referrals custom-form | internal-medicine | |
| McMaster – IUD Clinic Referral Form | Referrals | IUD, McMaster | Telus PS |  | Download | 4 December 2025 | referrals custom-form | iud mcmaster | |
| MedID Clinic – Infectious Diseases and Wound Care | Referrals | disease prevention | Telus PS |  | Download | 4 December 2025 | referrals custom-form | disease-prevention | |
| North Bay RHC – Outpatient Diagnostic Imaging | Imaging | obsp, Ultrasound, X-Ray | Telus PS |  | Download | 4 December 2025 | imaging custom-form | obsp ultrasound x-ray | |
| Social Communication Questionnaire (SCQ) | Miscellaneous | Pediatric | Telus PS |  | Download | 4 December 2025 | miscellaneous custom-form | pediatric | |
| Hamilton Health Sciences – Adult Epilepsy Clinic | Referrals | HHS, NAC | Telus PS |  | Download | 4 December 2025 | referrals custom-form | hhs nac | |
| Hamilton Health Sciences – McMaster – Obstetric Medicine Referral | Referrals | HHS, Internal Medicine | Telus PS |  | Download | 4 December 2025 | referrals custom-form | hhs internal-medicine | |
| Hamilton Health Sciences – Nuclear Medicine Requisition | Imaging | HHS, Nuclear Medicine | Telus PS |  | Download | 4 December 2025 | imaging custom-form | hhs nuclear-medicine | |
| Ontario Health atHome – Hospice Referral Form | Referrals | OHaH, Palliative | Telus PS |  | Download | 4 December 2025 | referrals custom-form | ohah palliative | |
| Hotel Dieu Shaver – Outpatient Referral Form 2023 | Referrals | Outpatient, Rehabilitation | Telus PS |  | Download | 4 December 2025 | referrals custom-form | outpatient rehabilitation | |
| LifeLabs – Carcinoembryonic Antigen (CEA) Req | Lab Requisitions | CEA, Lifelabs | Telus PS |  | Download | 4 December 2025 | lab-requisitions custom-form | cea lifelabs | |
| LifeLabs Genetics – Panorama Prenatal Screening Test – Private Pay | Lab Requisitions | genetics, Lifelabs | Telus PS |  | Download | 4 December 2025 | lab-requisitions custom-form | genetics lifelabs | |
| Medical Certificate of Death Form 16 (Full) | Miscellaneous | Ontario Health | Telus PS |  | Download | 4 December 2025 | miscellaneous custom-form | ontario-health | |
| Medical Certificate of Death Form 16 (Page 1) | Miscellaneous | Ontario Health | Telus PS | | Download | 4 December 2025 | miscellaneous custom-form | ontario-health | |
| Ontario Health atHome – HNHB – Iron Infusion Order Form | Referrals | OHaH | Telus PS |  | Download | 4 December 2025 | referrals custom-form | ohah | |
| Ontario Health atHome – HNHB – Palliative Symptom Response Order Form | Miscellaneous | HNHB, Palliative Care | Telus PS |  | Download | 4 December 2025 | miscellaneous custom-form | hnhb palliative-care | |
| Public Health Ontario – General Test Requisition | Lab Requisitions | PHO, public health | Telus PS |  | Download | 4 December 2025 | lab-requisitions custom-form | pho public-health | |
| Public Health Ontario – General Test Requisition – With Instructions | Lab Requisitions | PHO, public health | Telus PS | | Download | 4 December 2025 | lab-requisitions custom-form | pho public-health | |
| Public Health Ontario – Prenatal Screening Requisition | Lab Requisitions | PHO, Prenatal | Telus PS |  | Download | 4 December 2025 | lab-requisitions custom-form | pho prenatal | |
| Public Health Ontario – Prenatal Screening Requisition – With Instructions | Lab Requisitions | PHO, Prenatal | Telus PS | | Download | 4 December 2025 | lab-requisitions custom-form | pho prenatal | |
| Request for Boehringer Ingelheim – Medication Form | Miscellaneous | Medication | Telus PS |  | Download | 4 December 2025 | miscellaneous custom-form | medication | |
| LifeLabs – Cardiac Services – Holter & Blood Pressure Monitoring – With Info | Lab Requisitions | Cardiology | Telus PS |  | Download | 4 December 2025 | lab-requisitions custom-form | cardiology | |
| LifeLabs – Cardiac Services – Holter & Blood Pressure Monitoring | Lab Requisitions | Cardiology | Telus PS | | Download | 4 December 2025 | lab-requisitions custom-form | cardiology | |
| Hamilton Health Sciences – Diagnostic Imaging Consultation | Imaging | HHS, Ultrasound, X-Ray | Telus PS |  | Download | 4 December 2025 | imaging custom-form | hhs ultrasound x-ray |
Custom Form Archive (Older Forms)
Please note that forms in the Archive are not updated and do not have a preview image.
| Form | Form Categories | Subject | EMR | 1st Page Preview | Form Location | Link | Date Modified |
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