Requisition Forms

Click on your region below to download a PDF requisition, then CLICK HERE to find your nearest MyHealth Centre with contact information.

If you are a referring healthcare provider, please CLICK HERE for more information.

General Requisitions for Cardiology & Radiology Services:

• Greater Toronto Area
• Huntsville
• Lindsay
• Sault Ste. Marie
• Southwestern Ontario (Brantford, London, Sarnia & Simcoe)
• Sudbury – Cardiology
• Sudbury – Radiology

Specialty Requisitions:

• Brampton – Sleep Disorders
• London – Pain Injections
• Mississauga – PET/CT
• Ontario – Same-Week Cardiology Consultations at Cardiology Now