Lakeridge Health Gynecologic Oncology Referral eForm

Provided by Leo Pavone
Open Source Clinical Applications and Resources
Open Source Clinical Applications and Resources
Provided by Leo Pavone
Provided by Leo Pavone
The fax number has changed. I have written a line to overwrite the old number with the new one. 2020-Sep-08 15:54. This form was created by Jan Nusche with some additions by myself (John Robertson)
2020-Feb-06 19:57 Level of Urgency Table is now clickable. Created by James Saunders. Referral to the Gynecologists working in the Vancouver Island Health Region in and around Victoria
This is the new form for referral to BCWH RPL. It has some required fields and some colour changes when “sub Xboxes” are required. JohnR
Created for Colposcopists working with the BC Cancer Agency.
Referral form to Dr. Geoffrey W. Cundiff and Dr. Roxana Geoffrion at the Centre for Pelvic Floor Competence. Referral form toggles between the 2 surgeons and their areas of expertise.