Referring a Patient

Referral Process To The London Multiple Sclerosis Clinic

Referrals for consultation or for reassessment should be faxed to one of the following physicians office.  Please note they do have their own fax lines and practices, please only fax to one office.  Please provide a fax cover sheet with your contact information, as well as your OHIP billing number.

  • For Dr. Juan Racosta please fax to: 519-663-3091

In order to prioritize and assign a level of priority to your referral, the following information must be provided:

  1. Patient demographics, including the name of the patient's family doctor
  2. Reason for referral
  3. Current medical history and physical findings
  4. Specialist consult notes
  5. A list of all medications
  6. All relevant lab investigations (ie: MRI reports, CSF analysis, blood work)
  7. Please ensure the patient brings their MRI CDs with them to the appointment (only if the MRI has been done at a facility other than London Health Sciences Centre or St. Joseph's Health Care London).

The referring office will be notified by fax of the date and time of the patient's appointment.

**Please notify the patient of this appointment and have the patient call the MS Clinic office (519-663-3697) to confirm this appointment. IF THE PATIENT FAILS TO CONFIRM THE APPOINTMENT AT LEAST TWO WEEKS PRIOR TO THE APPOINTMENT, THE APPOINTMENT WILL BE CANCELLED.**

PLEASE NOTE: 
Due to human resource constraints, all patient referrals to the London Multiple Sclerosis Clinic will be reviewed and assigned a level of priority for appointment. Referral to the MS Clinic will not guarantee that an appointment will be given.