Referral forms


Click below to download forms:

 

 

We accept referrals from family physicians, specialists and nurse practitioners, physiotherapists and occupational therapists. Please fill out the referral form above and send by fax to Southland EMG, Fax: (587) 481-7877. A consultation will be provided with an EMG assessment.

 

Current wait-times:

  • EMG/NCS evaluation: two to six months
  • General Physiatry evaluation: three to six months
  • Ultrasound guided assessment and peripheral injection: two to three weeks