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Page 1 of 1MEDICAL URGENT CARE CLINIC REFERRALPatient Label impatient Referral FormTelephone: 9058831212 Ext. 2064Fax: 9058830772Patient Information Last Name:First Name:Address: City:Province:Home
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01
Gather all necessary personal information such as name, address, contact number, and insurance information.
02
Arrive at the clinic and check in at the front desk.
03
Fill out any required forms or paperwork provided by the clinic.
04
Wait to be called back by a medical professional for your examination and treatment.
05
Be honest and thorough when describing your symptoms and medical history to the healthcare provider.
06
Follow any instructions or prescriptions given to you by the provider before leaving the clinic.

Who needs medical urgent care clinic?

01
Anyone experiencing a sudden illness or injury that requires prompt medical attention but is not severe enough to warrant a trip to the emergency room.
02
Individuals without a primary care physician or who are unable to get an appointment with their regular doctor in a timely manner.
03
Visitors or travelers who need medical assistance while away from home.
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A medical urgent care clinic is a facility that provides immediate medical care for acute illness or injury that is not life-threatening.
The medical staff or administrators of the urgent care clinic are required to file the necessary paperwork.
The medical urgent care clinic form must be completed with all relevant patient information, medical history, treatment provided, and any follow-up instructions.
The purpose of a medical urgent care clinic is to provide quick medical attention for non-life-threatening conditions to patients who cannot wait for a regular doctor's appointment.
Information such as patient demographics, chief complaint, vital signs, diagnosis, treatment provided, prescriptions, and follow-up recommendations must be reported on the medical urgent care clinic form.
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