How to Make a Referral

Clinicians can make a referral to GeriMedRisk by:

eConsult: Ontario Telemedicine Network or Champlain BASE™ eConsult

Ontario Telemedicine Network eConsult (Specialty or Recipient: GeriMedRisk)

Champlain BASE™ eConsult (Specialty: GeriMedRisk)

Ocean eReferral:

Ocean eReferral select “GeriMedRisk” on the Waterloo Wellington Specialized Geriatric Service Clinical Intake Form

Specialized Geriatric Services (SGS) Intake Forms

Regions: Champlain, Hamilton Niagara Haldimand Brant and North Simcoe Muskoka

Click on the region below to download intake form:
North Simcoe Muskoka

Champlain

Hamilton Niagara Haldimand Brant

Telephone: 1-855-261-0508

(Call Toll-Free Monday to Friday: 9 am- 5 pm)

Fax: (519) 279-2959

Please email gmrfax@gerimedrisk.com to confirm the fax has been received

What is GeriMedRisk?

Download One Page PDF Document

GeriMedRisk Referral Form

Physicians, nurse practitioners and specialists are welcome to submit a referral for their patient by fax using this referral form.

Download Referral Form

Suggest a GeriMedRisk Referral

Allied health care professionals can use this referral communication form below to communicate medication-related, physical and mental health concerns to their older patient's primary care clinician when a GeriMedRisk consult may be appropriate. This form provides the primary care provider with clinical information and can be used as part of the referral to GeriMedRisk from primary care, should they wish to consult.

Download Form for Allied Health Care Professionals:

Download Referral Communication Form

General Inquiries

If you are interested in hearing more about GeriMedRisk, please contact us using the form below.