Doctor Referral Form — St. Catharines — Canadian Foot Clinic & Orthotic Centre

Referral Form for physicians & patients — print, fax or bring to appointment. OHIP does not cover chiropody; private plans may. New patients welcome.

Download our Referral Form:

Medical Clinics can print this form for patient referrals to our clinic. Please call our office at 905-346-0222 for our fax number.

Patients can also print this form to give to their family doctors to clarify their needs.

(Note: referrals are not required but certainly appreciated.)

OHIP does not cover chiropody services.

Chiropodist visit charges may be covered by your extended health insurance benefit plan.

We are accepting new patients!