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Click ‘Get Form’ to open the MS Clinic Referral Form in our platform's editor.
Begin by entering the patient's name, home address, postal code, date of birth, and sex in the designated fields. Ensure all information is accurate for proper processing.
Fill in the referring doctor's information, including their name, contact details, and provider number. This section is crucial for communication regarding the referral.
Specify the reason for referral by selecting from options such as 'New Patient' or 'Referral for Follow-up.' Provide detailed descriptions of major concerns or symptoms in the space provided.
Complete the required reports and diagnostics section by indicating any recent medical history and findings, including MRI results and other assessments as necessary.
Finally, ensure that the referring physician signs and dates the form before submission. This step is essential for validation.

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What is an MS clinic?

We provide expert care for multiple sclerosis (MS) and related neurological conditions. We offer coordinated treatment, ongoing support, and access to the latest therapies.

Is MS an urgent referral?

If a person has symptoms and signs suggestive of multiple sclerosis (MS): Refer promptly to a consultant neurologist early diagnosis and treatment may improve prognosis.

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St michael's Hospital MS Clinic Referral MS Clinic near me MS Clinic Toronto MS Clinic Mississauga Victoria MS Clinic Barlow Clinic Multiple sclerosis ontario

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MS Clinic Referral Form 2026