Referring your patient to the Prenatal Diagnosis and Medical Genetics Program

• Complete the PDMG referral form (35 KB pdf ), requesting the appropriate reason for referral.
• Please make sure to include any relevant antenatal records, eg. ultrasound reports, screening results, lab results, etc.
• Fax the PDMG referral to 416-586-8384.

Appointments will be faxed back to your office. Your office is responsible for informing the patient of the appointment

Referring your patient to the Late Maternal Age (LMA) Clinic

• Complete the PDMG referral form (35 KB pdf ), requesting Late Maternal Age Consult.
• Please indicate if you would like your patient to do the Nuchal Translucency (NT) ultrasound as part of this appointment for First Trimester Screening (FTS) or Integrated Prenatal Screening (IPS) by checking off “YES” or “NO”.
• If yes, please complete the CEOU (Centre of Excellence in Obstetric ultrasound)  requisition form (43 KB pdf ) requesting NT SCAN.
• Fax both the PDMG referral AND (if requested) the CEOU requisition to 416-586-8384.

Appointments will be faxed back to your office. Your office is responsible for informing the patient of the appointment.

Referring your patient for Nuchal Translucency (NT) Ultrasound

• Complete the CEOU requisition form (43 KB pdf ) and fax it to 416-586-8384.
• Appointment will be faxed back to your office.
• Your office is responsible for informing the patient of the appointment.
• Please have your patient bring the completed blood requisition for FTS or IPS at the time of the appointment. Download the requisition and fill in online (480 KB pdf ).  Alternatively, you can fax the blood requisition with your appointment request (as complete as possible) and the patient will be given the requisition following her NT ultrasound.

For more information please Contact Us.