How to Make a Referral

At Victoria Hospital:

Referrals from LHSC Physicians/Delegates and or Physicians with Admitting Privileges to LHSC only are accepted for:  

  • Standard Hearing Assessments (Audiogram) 

Referrals are accepted from all LHSC and community physicians for:  

  • Auditory Brainstem Evoked Response Assessments 
    • Hearing Threshold Protocol (Sedated ABR for children) 

Referrals from LHSC and community otolaryngologists or neurologists only are accepted for:  

  • Auditory Brainstem Evoked Response Assessments 
    • Neurological Protocol    

Referrals can be made through order entry in the Electronic Patient Record or by faxing VH Audiology at 519-685-8077.

When referring a patient, physicians are to indicate their referring service/program.

View the Referral Form for Victoria Hospital Audiology

Note: In order to accept a referral for Sedated ABR Assessment, it is essential that evidence of following are included:

  1. Multiple behavioural hearing assessments
    • Recommended to be completed by a CASLPO Registered Audiologist; for resources in your area, please see the CASLPO website 
    • If behavioural thresholds cannot be obtained please state the reasons why
  2. Infant Hearing Program (IHP) status of patient  
    1. To obtain information regarding the patient’s hearing screening at birth and/or current IHP status contact the IHP location in your area, please see the Infant Hearing Program.

At University Hospital:

Referrals from LHSC and community otolaryngologists or neurologists only are accepted for:  

  • Cervical Vestibular Evoked Myogenic Potentials (VEMP)
  • Video-Nystagmography (VNG)
  • Neurological Auditory Brainstem Evoked Response (ABR)
  • Electrocochleography (ECOG)

Referrals can be made by faxing UH Audiology at 519-663-3916.

View the Referral Form for University Hospital Audiology

Make a referral to the Cochlear Implant Program here.