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Diabetes Clinic

Referrals form

Referrals process

A physician or midwife may refer women to the clinic. Upon referral, each woman is assigned to the care of an endocrinologist. You may obtain a referral form from the clinic and fax it along with Parts 1 and 2 of the prenatal record, the latest ultrasound, and any other pertinent information. You can also download the referral form at the bottom of this page.

The criteria for referral are as follows:

  • type 1 diabetes
  • type 2 diabetes
  • gestational diabetes
  • abnormal 50 gm screen
  • transfer of care
  • overt hyperglycemia
  • previous gestational diabetes
  • asymmetrical macrosomia
  • polyhydramnios
  • pre-pregnancy counselling (type1, type 2, pre-diabetes)

Please note:  Incomplete referral forms will not be processed

The clinic desk is open from 8:00 a.m. to 4:00 p.m. Monday to Friday, except for statutory holidays.
Phone: (604) 875-3135
Fax: (604) 875-3041

SOURCE: Diabetes Clinic ( )
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