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, Ticlid, Pradex, or other blood thinners
- is on continuous narcotic use
- uses CPAP for sleep apnea and has a BMI >35
- is morbidly obese (BMI > 40)
- age > 80
Patients deemed to be high risk should be referred to one of our gastroenterologist's office for consult.
STEP 2: Fax the completed Patient Referral Form to the VEC at 905-856-2602.
STEP 3: 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. The clinic will provide the patient with the bowel preparation instructions and informed consent documentation.
