Diagnostic Requisitions (physicians only)

Our Diagnostic Imaging and Cardiac Department is now live on the Ocean eReferral Network. 

• Access our Ocean Healthmap listing for Diagnostic Imaging here 
  
  
• Access our Ocean Healthmap listing for Cardiac Diagnostic Services here

We encourage you to consider taking advantage of this Ministry of Health-funded initiative which is free for both senders and receivers. It greatly simplifies and streamlines the referral management process as it provides a more effective means to submit, process, and track referrals over the traditionally paper-based Fax referral process. Referrals received through this mechanism will be consistently clearer and comprehensive and will provide an improved ability to communicate more effectively and efficiently with both the referring providers and patients.

Need Help?

You can contact the local support team for additional information on eReferral and for assistance with their easy onboarding process at contact@ereferralontarioeast.ca. 

These requisition forms are for physicians to complete only. They are not intended for patients.

No Diagnostic Imaging exam will be performed at WDMH without a fully completed requisition signed by a licensed physician. Any requisition that appears fraudulent will be investigated immediately and imaging services WILL NOT be provided.

Diagnostic Imaging Requisition Form
Cardiac Diagnostics Requisition Form
CT Requisition and Prep Form
CD Request Form