Patient Referral Form

Please complete and submit the following form to refer your patient to Trident Medical.

Please note

All referrals must include specific imaging or investigations as listed below. Incomplete referrals will delay care or may be refused.

Peripheral Joint Pain/Arthritis: X-Ray, CT or MRI

Soft Tissue Pathology: Ultrasound or MRI

Radiculopathy: CT or MRI

Peripheral Mononeuropathy: EMG

Neuropathy: EMG

We are not able to see patients for:

  • Medication Management

  • Opioid Prescription Management

  • Ongoing Longitudinal Care

Due to resource limitations:

We are unable to see patients who have untreated addictions or psychiatric conditions. We are unable to see patients unattached to a family physician or a nurse practitioner.