Referral Source

Patient resides within the Mountain Park Region:

• Physicians, Physiotherapists and Chiropractors with a valid practice ID are welcome to submit a completed BSM Referral Form or their own letter along with required information indicated below.

• Mountain Park Region comprises of the following areas – (from Banff):

West: to Revelstoke, through Golden (including Hwy 95 south to Fairmont Hot Springs)

East: to Morley and Ghost Lake (excluding Bragg Creek, Redwood Meadows and Cochrane)

North: to Jasper (excluding communities outside park boundaries)

South: to Fairmont Hot Springs (including Hwy 95 north to Golden)

Patient resides OUTSIDE of the Mountain Park Region:

• General Practitioners, Sport Medicine Physicians, Orthopaedic Surgeons, Physiotherapists, Chiropractors and other rehabilitation and musculoskeletal specialist physicians with a valid practice ID are welcome to submit a referral along with required information indicated below.

Required Information

The following information MUST be included with each referral:

• Patient: full name, address, date of birth, PHN, contact phone numbers and email addresses, height and weight, the reason for the referral, any recent investigative tests or diagnostic imaging results, and relevant past medical history.
• Referrer: full name, practice ID number, contact phone number

Acceptance/Refusal of Referrals

• In accordance with CPSA guidelines, within 14 days of receiving a referral our office will either advise the referrer and the patient that the referral has been accepted, or advise the referrer the referral has been declined.
• Our office will either contact the patient to book an appointment as soon as the referral is accepted or we will advise the patient that we will call back once an appointment becomes available.

Resources
BSM Referral Form (637 KB)

Standardized X-ray Views

Patient Information