For Referring Practitioners
Referral Forms
Download and print Athleticare referral forms for patient referrals to our multidisciplinary health clinic at West Edmonton Mall.
Athleticare Referral Form
General patient referral form for all Athleticare services including physiotherapy, sports medicine, chiropractic, massage therapy, and allied health disciplines.
Diagnostic Imaging Requisition
Requisition form for diagnostic imaging referrals including X-ray, ultrasound, and other imaging services. For use by referring practitioners.
Questions About Referrals?
For questions about the referral process or to discuss a patient case, contact Athleticare directly.
Athleticare · Unit 2052, 8882 170 St NW, Edmonton, AB T5T 3J7 · West Edmonton Mall