BILL C-14
CPSBC GUIDELINES
FAQ'S
How to fill out a
Patient Request?
How to fill out an Assessment Form?

How to refer your patient.....

 

  1. Fill out Referral Form with pertinent medical records,
  2. Attach Patient Request Record (filled out by the patient requesting MAiD)
  3. Attach Assessment Record (filled out by you)

 

 

 

 

* Please do not send until all documents are complete and fax to 250 480 7339*

 

Dr. Konia Trouton will address questions and concerns throughout the consultation process. 

HEALTHCARE PROFESSIONALS