Physician Instructions
Steps for Patient Referral:
Please print and complete the VEC Patient Referral form and fax it to the clinic at 905-856-2602.
STEP 1: Check that your patient meets the VEC health criteria.
Please note that the patient should not be referred to the VEC if they have any of the following criteria:
- has significant/severe GI complaints
- has significant cardiovascular, respiratory, renal, neuro, or liver disease
- had a heart attack <= 1 year, or has cardiac stents
- is an insulin dependent or brittle diabetic
- requires prophylactic antibiotics for previous endocarditis, mechanical heart valve, or complex cardiac congenital abnormalities
- is on Coumadin, Plavix, or s.c. heparin, or Ticlid
- is on continuous narcotic use
- uses CPAP for sleep apnea
- is morbidly obese
Patients deemed to be high risk should be referred to one of our gastroenterologist's office for consult.
STEP 2: Provide required documents to the patient.
As the referring physician, you should provide your patient with the following documents when you submit the request for colonoscopy:
Alternatively the patient can get these forms directly from the VEC by fax, mail or email. The referring physician is not expected to explain the procedure or witness the consent. If the patient has any questions they can call the VEC to discuss them.
STEP 3: Fax the completed Patient Referral Form to the VEC at 905-856-2602.
Upper endoscopies are not individually provided at the Vaughan Endoscopy Clinic. However, if the patient is having a colonoscopy done and they have symptoms that warrant gastroscopy at the same visit, please indicate that on the referral form and provide the patient with the Gastroscopy Informed Consent form, in addition to the other documentation.
STEP 4: Once the Patient Referral Form and the Medical History Form are received, the VEC will contact the patient directly to schedule a convenient appointment for them.
