Calgary Foot & Ankle Clinic
For referring physicians

Refer a Patient

Please download and complete the standardized referral form below, or complete it in Accuro. Completed referral forms can be faxed to 403-319-0048.

Referral Form

Download referral form (PDF) ↓

The form can be filled out directly in your browser before printing, or downloaded and completed in your PDF viewer or EMR.

Please ensure the patient has up-to-date weight-bearing foot and ankle X-rays.

What Happens Next

Once your referral has been received, our office will review and triage it. When an appointment becomes available, our office will contact the patient directly by telephone to schedule their visit.

Diabetic Foot Complications, Ulcerations and Charcot Deformity with Ulceration: Please refer patients to the Zivot Limb Preservation Centre.

Where to Send Referrals

Fax
403-319-0048
Telephone
403-221-8345
Mail
Calgary Foot & Ankle Clinic
2225 MacLeod Trail SE, North Building
Calgary, AB T2G 5B6