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Place patient sticker here Substance Use & Concurrent Disorders Program Rapid Access Addiction Medicine (RAAF) Clinic The Royal, 1145 Calling Ave., Ottawa ON K1Z 7K1 Phone 613.722.6521, ext. 6508Fax

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How to fill out referral form - ottawa

01

Obtain a copy of the referral form from the relevant department or organization in Ottawa.

02

Read the instructions on the form carefully to ensure you provide all required information.

03

Fill out the patient's personal details, medical history, and reason for referral accurately.

04

Attach any supporting documents or test results as specified on the form.

05

Submit the completed referral form to the appropriate office or healthcare provider as instructed.

Who needs referral form - ottawa?

01

Individuals who require specialized medical services or consultation from a healthcare provider in Ottawa may need to fill out a referral form.

02

Patients who have been recommended by their primary care physician or other healthcare professional for further evaluation or treatment may also need to fill out a referral form in Ottawa.

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What is referral form - ottawa?

Referral form - ottawa is a document used to refer individuals to services or programs in Ottawa.

Who is required to file referral form - ottawa?

Any individual or organization who wishes to refer someone to services or programs in Ottawa.

How to fill out referral form - ottawa?

To fill out referral form - ottawa, you need to provide necessary information about the person being referred and the reason for the referral.

What is the purpose of referral form - ottawa?

The purpose of referral form - ottawa is to connect individuals with the appropriate services or programs in Ottawa.

What information must be reported on referral form - ottawa?

Information such as contact details of the person being referred, reason for referral, any relevant medical information, and contact details of the referrer.

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