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Forms

For third-party requested forms or reports, an appropriate assessment fee may be charged in addition to the fee charged for completion of the form/report, when the assessment is not medically necessary.

Forms for patient use

Form Name (Download)
Travel Questionnaire (Fillable PDF)
UOHS Ontario Patient Application for Fee Exemption (Fillable PDF)
UOHS RAMQ Patient Application for Fee Exemption (PDF)
Application for Reimbursement (RAMQ) (PDF)
UOHS Preventive Health Assessment (Fillable PDF)
Consent to Release Personal Health Information (PDF)
Concussion Assessment (PDF)
Nipissing District Developmental Screen (PDF)
Primary Health Care New Patient Declaration (PDF)
International prostate symptom score (PDF)
Privacy - Patient Lockbox Request (PDF)
Other  

 

Forms for referring providers

Form Name (Download)
Sports Medicine Referral Form (Fillable PDF)
IUC Referral Form (PDF)
Rheumatology - Musculoskeletal Ultrasound Referral Form (PDF)
Capital EMG physiatrists Referral form (Fillable PDF)
PS suite users can find and download a CFM copy of UOHS Custom Forms on the TELUS Community Portal within the files for the Chatter group for Custom Forms Sharing  CFM

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Hours of Operation

Walk-in Clinic
100 Marie Curie, Ottawa

Monday: 8 AM - 8 PM
Tuesday: 8 AM - 8 PM
Wednesday: 8 AM - 8 PM
Thursday: 8 AM - 8 PM
Friday: 8 AM - 8 PM
Saturday: 10 AM - 2 PM
Sunday: 10 AM - 2PM

Contact

300-100 Marie Curie Pvt
Ottawa, ON
K1N 6N5

Tel: 613-564-3950

Fax: 613-564-6627

After Hours Access to Care

Patients registered with a family doctor at UOHS

In case of emergency, always dial 911. THAS connects you to a nurse who can provide medical advice, or, if appropriate, provide access to a family health team doctor or suggest that you go to emergency.

1-866-553-7205

Patients not registered with a family doctor at UOHS – Ontario residents

In case of emergency, always dial 911. Telehealth Ontario is a free service that allows Ontario residents to speak to a Registered Nurse with their medical questions any time of the day or night. This could be when you're sick or injured but aren't sure if you need to see a doctor or can treat the situation at home.

1-866-797-0000

Patients not registered with a family doctor at UOHS – Quebec residents

In case of emergency, always dial 911. Info-Santé 8-1-1  is a free and confidential telephone consultation service that puts you in contact with a nurse in case of a non-urgent health issue.

Info-Santé 811

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