The following information must be included on all written referrals:

Patient Name
Personal Health Number
Patient Address
Patient Telephone Contact Information
Patient email address
Referring Physician Name, Contact Information and Practioner ID
Date of Referral
Purpose of the Referral
Pertinent clinical information including investigation results - requirements per presumptive diagnosis
All imaging studies not performed in Alberta/North Zone and are not available on Netcare need to be supplied to the patient in CD format.

ALL NEWBORN PEDIATRIC REFERRALS must be discussed with the Surgeon On Call prior to sending a written referral

Referrals