Diagnostic Testing and Consultation Request Form

Information on this page is meant for Physicians.

Requisition forms will need to be completed and signed by a Physician. Diagnostic Testing and Cardiac Consultation requests may be done on the same form. In requesting a consultation you may specify a Cardiologist or may request the first available.

To help with deciding the appropriate testing please follow the link for Appropriateness Criteria.

Please fill out as much information as possible. Indication for testing is mandatory. The form can be filled out electronically and printed.

Please fax the complete form to (905) 849-8266.

Download Requisition

diagnostic testing