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OPT/CT Referral


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Online OPT/CT Referral


You may refer patients to our centre by completing our Online OPT/CT Referral Form. You can also download our PDF OPT/CT referral form. After you have completed the form, please post or fax it to us. The security of your patients’ personal data is one of our primary concerns and we have taken every precaution to protect it.

To download our referral form please click here: Download OPT/CT Referral Form

For our online referral form please click here: Online OPT/CT Referral Form

Technical Note:

You need Adobe Acrobat Reader to view our form. Please download the free Acrobat Reader from Adobe's web site if it is not already installed on your system.