Referral Forms

As a specialized clinic, we are not able to accept requests for appointments directly from patients. We welcome direct referrals from all physicians. Referrals from physicians can be made directly to the clinic using our referral form. Patient referrals can be faxed to us at: (416) 321-5162. Within two business days of receiving the fax, we will contact your patient directly to:

  • Schedule an appointment
  • Provide preparation instructions
  • Provide helpful material that answers common questions about the procedure

A patient referral form is provided below for your convenience as an Abode PDF file. Click on Adobe Reader if you don’t have it or need to upgrade to the latest version.

Download Referral Form

We can supply your practice with a referral pad, endoscopist profiles, patient information brochures, and preparation instructions. To have our printed materials sent to your clinic, please contact us at:

GTA Endoscopy Services Inc.

305 Milner Ave, Suite 920,
Scarborough, ON, Canada
M1B 3V4

Phone: (416) 321-3883
Fax: (416) 321-5162
Email: info@gtaendoscopy.com