In order to be seen by our physicians, we require a referral form, which you can obtain from your family physician.

Please have your referring physician send the referral form to us in order to ensure that you will be seen as soon as possible.

If your physician is not familiar with Wilderman Medical Clinic and our services, you may direct them to our website, or have them give us a call. A new referral form is required every 24 months if the patient is not seen regularly.

Download the Wilderman Medical Clinic Referral Form here: Wilderman Medical Clinic Referral Form (PDF)