Referral Form

Shield Clinics is accessible via referral only. Physicians, use the referral form found here.
Fax completed forms to 780.666.2621.

Ultrasound-guided Injection Referral Form

Shield Clinics is proud to announce our Ultrasound-guided Injection Clinic. We are accepting referrals now, and we will strive to see patients as soon as possible. The mandate of this clinic is to provide a focused musculoskeletal assessment combined with the requested injection during the same appointment. This is to ensure that we provide the most suitable treatment(s) for the patient and to improve their clinical outcome. A follow-up appointment will also be arranged after the injection to guide further management.

Please fax the completed forms to 780.666.2621.