Please Note: The following documents are for use by healthcare professionals only. If you have a new version of a form to post please e-mail it to mlougheed@gbhs.on.ca.
Cardiac Rehabilitation
Cardiology
Diabetes
Diagnostic Assessment Clinic
Geriatric
Lab Requisitions
Medical Assistance in Dying (MAID)
- MAID referral form to SW LHIN
- Clinician Aid A Form – for patient
- Instructions for Completing Clinician Aid A form
Medical Imaging
- CT Requisition
- CT Spine Appropriateness Checklist
- General Medical Imaging Requisition
- Interventional Radiology Request
- MRI Breast Questionnaire
- GBHS MRI Requisition
- Regional MRI requisition
- Mammography and Breast Screening Requisition
- MRI Knee Appropriateness Checklist
- MRI Spine Appropriateness Checklist
- Patient Preparation for Imaging Tests
- Request for Bone Mineral Densitometry