Cambridge Memorial Hospital is pleased to accept physician e-Referrals directly from our website:

• Diagnostic Imaging eRequisition Form  (for x-rays, mammogram, bone densitometry, CT, ultrasound, nuclear medicine and MRI) 
   
• You may also send an eReferral to us using the local health service directory OceanHealthMap.ca.

For Telus Practice Solutions, Oscar and Accuro EMR users 

• Please see below to download custom forms that send eReferrals directly to CMH from your PS Suite EMR (with no additional login required). 
   

PS Custom Form for Ocean eReferrals  (needed by all DI eReferral forms)

• https://s3.amazonaws.com/ocean.pss/Ocean+eReferral.cfm   (right click -> Save As to download the file) 
   

PS Custom Form for Diagnostic Imaging eRequisition 

• https://s3.amazonaws.com/ocean.pss/CMH+Diagnostic+Imaging+eRequisition.cfm (right click -> Save As to download the file) 
   

Click here for installation instructions. Note: please ensure that you install the custom forms in your clinic before attempting to send a referral. 
 

e-Referral Support

If you require assistance with your e-referral, please contact us. 

• E-mail:   ereferralsupport@cmh.org 
• Diagnostic Imaging:  (519) 621-2333 ext. 2230 
• MRI:  (519) 621-2333 ext. 4968

For other EMR users or those without an EMR

• If you do not wish to send an eReferral, faxed referrals are still acceptable.

Diagnostic Imaging Referrals (fax forms)

• Breast Imaging Requisition
• Bone Mineral Density Requisition
• CT Requisition
• General X-Ray Requisition
• Ultrasound Requisition
• Nuclear Medicine Requisition
• MRI Requisition

Fax Numbers

• MRI Referrals:(519) 740-4969
• DI Referrals: (519) 740-4904