Created for the Surrey North Delta Division of Family Practice. For PHS patient referral to Jim Pattison Outpatient Care. There may be certain measurements that need to be added for full functionality – as per John Yap.
Updated referral form for the BC Women’s Hospital Fetal Diagnostics Services. It does a few extra things like remind you to fill required fields and it has a button to calculate the estimated gestational age.
Now that severe pulmonary illness associated with Vaping has become a mandatory reporting issue, Fraser health has created a VAPI (vaping associated pulmonary illness) reporting form. Now as an eForm.
Updated Maternal Fetal Medicine Referral eForm as requested by the Surrey North Delta Division of Family Practice. The image for this form still dates back to 2012. The form I was given has been photoshopped to remove the 2 separate fax numbers and replaced with a single central fax referral line (which is the same as the old Jim Pattison OCSC fax number). As such, I have used HTML overlay to “edit” the original image. If you have previously uploaded this form, the image is unchanged and does not need to be uploaded (and won’t be from the zip file). There were problems with the previous code and it would not zip and unzip properly. This has been solved, and other aspects of the code such as radio X boxes have been updated. JohnR.
New background as of September 2019. Updated by John Yap.
Referral eForm for Synergy Rehabilitation.
For referral to the Specialized Seniors Clinics in Fraser Health
Eform Created by Crystal Ross
Form Name: Postpartum Contraception and IUD Clinic Description:Contraception and IUD insertion and counselling
Form Name: Maternity Clinics Dietician Referral Description:For pregnancy concerns related to inadequate/excessive weight gain, poor nutrition