Referral Forms
Referrals are accepted from family physicians, nurse practitioners, and specialists across British Columbia. All visits are virtual.
What to include
• Patient's full name as it appears on their Care Card, plus date of birth and PHN
• Patient email and phone — the office contacts patients by email with dates and next steps, so a current address matters
• Which service you are referring to — perimenopause and menopause, disease-specific consultation, or prehabilitation
• a brief note on the presenting concern and what has been tried so far
• current medications, and any relevant recent bloodwork or investigations
• For prehabilitation referrals — please include the planned procedure, the surgery date if known, and the surgeon's name. Earlier referral allows more time to prepare the patient.
What happens next
Our office confirms receipt with you, then contacts the patient directly by email with available dates and their intake package. Patients are typically contacted within one week of the referral arriving.
A consultation summary and recommendations are returned to you after the visit. For prehabilitation referrals, the summary also goes to the referring surgeon.
Eligibility
Group medical visits are covered by MSP for referred patients with active BC coverage. An active referral is required. Patients must be BC residents, as all care is delivered virtually within the province.
Questions
Email care@shannonlockhartmd.com, or see the For Physicians and NPs page for detail on when to refer to each service.
—————————-
Are you a patient? Download a form above, bring it to your next appointment with your family doctor or nurse practitioner, and ask them to fax it in. See the New Patients page for what happens after that.