Hip and Knee Referral Template

Alberta Bone and Joint Clinical Network


Referring physicians must use the provincially endorsed Alberta Bone and Joint Clinical Network Hip and Knee Referral template for all hip and knee replacement patients.

Include with each completed referral form a relevant history or EMR record and the appropriate x-ray report (indicated on the form).

Download the Hip and Knee Replacement Referral Template.
Fax the completed referral package to ONE of the following clinics:

Calgary  403-221-4387 Lethbridge  403-329-2136
Camrose  780-679-2630 Medicine Hat  403-528-8163
Edmonton  780-432-6395 Red Deer  403-358-5808
Grande Prairie  780-402-9829 Westlock  780-349-6686

Care Path Design
Patient Guides for different bone and joint surgery types, such as hip and knee replacements.

Excerpt Alberta Bone and Joint Health Institute

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