Personal tools

BC Specific

BC Cancer Agency eForms
For referral to services at the BC Cancer Agency
BC Children's Hospital ( BCCH ) forms
Forms to be used for referrals to, or tests done at BCCH
Sunny Hill Referral eForms for Pediatric Referrals in BC
BCWH eForms
Eforms specific to BCWH or for tests done at BCWH
Campbell River, BC and Comox, BC specific forms
Specific E-forms used locally at the Campbell River Hospital (CRG/CRH), Comox Valley Hospital (CVH), and in the communities of these two cities on Vancouver Island. For sharing by the local cluster of OSCAR users
Fraser Health Authority (FHA) specific forms
Interior Health Authority Forms
Northern Health Authority
Eforms for BC's Northern Health Authority Including University Hospital of Northern British Columbia (Prince George).
Providence Health eforms
These are forms for use in the Providence Health Authority of British Columbia including St. Paul's Hospital and Mt. Saint Joseph Hospital.
VCH specific forms
Vancouver Coastal Health specific e-Forms.
VIHA specific forms
This folder will contain e-forms specific for VIHA, as requested by Oscar users in this area. More to follow. Stay tuned.
Complex Care Plan
GF Strong Outpatient Rehabilitation Referral Form
Updated Aug24_2017
Medication Coverage
Collection of Special Authority forms/drug coverage forms/etc - Special Authority Forms are now being rejected (Feb 2015) unless there is a 'wet' signature. Forms have been updated to reflect this. Also an attempt was made to increase font size where possible to improve legibility.
Patient Conference
Personal Health Risk Assessment-Screening
For use with fee item 14066 in BC
BC NeuroPsychaitry Referral
Referral to UBC NeuroPsychiatry Clinic
Personal Health Risk Assessment 2011
Walk in Spirometry Centre Vancouver Costal Health
Provided By John Yap - NB Drop Down lists on this form reset.
BC Centre For Sexual Medicine Referral Form
Three page form - all HTML, but requires "blank pages" to allow for proper page breaks. This page has been used in other forms, so you may have it already in your image library
BC Centre for Disease Control Serology Form updated 2019
Updated 2019-Oct-03 11:18 with Sep2019 background. Updated October 2017 - From Herb Chang - There was a small glitch in the BC CDC serology form. The 'Prenatal' Button had the same name as the Reason for Test Prenatal Check Box, so that it would not get checked. I changed the name of the Prenatal Button and it now works correctly. Also removed copies of the serology reports to Royal Columbian Hospital--not sure the caseroom would want that. -----As Requested By Jel. Uses X boxes, has a time stamp, and a counter so the time stamp does not update the next time the form is opened.
BC CDC PHSA Lab Requisition for Bacteriology and Mycology Page 1
This is a double sided form, but as the second page is completely separate and used for Isolates Submitted for Identification, I have elected to do the pages separately.
BC CDC PHSA Lab Requisition for Bacteriology and Mycology Page 2
This is to send to the Provincial Lab for further testing - it appears it would most commonly be used by smaller Labs.
BC CDC PHSA Lab Requisition for Parasitology
Prenatal Library
Palliative Care Project - David Page
As presented at the May 2012 BC Oscar Meeting
Residential Care Project
As presented by David Page at the 2012 BC Oscar Meeting
Perinatal Services of BC Levels of Service Document
Ranking of complexity of obstetrical patients
Mobile Lab
BC Bio Mobile lab form for shut ins etc
End Of Life Planning
Forms for End of life planning
Handy Dart Application Form
Created by John Yap
Wound Clinic VGH
Managed to get an original pdf for the wound clinic at Vancouver General Hospital. It had to be modified to be useful, and grammatically correct! JohnY
Ultrasound/Fetal Monitoring Requisition for BCWH
By Kevin Meyerink
Complex Care December 2012
This is an HTML only (no image) - Updated form from John Yap: From the header <!-------Updated Dec 2012: includes diagnostic R, CLD, and CND codes; additional Resp/CND conditions suggested; CLD criteria-----------> - primarily for BC users. I have tried to update the complex care form developed by the Chilliwack group. But with the introduction of 2 new categories, one of which has a variety of different conditions with no well-defined guidelines, it's not so easy following the same format as the great work already done. If anyone has good references for some of these other conditions, please let me know and I will add the links. For now, I have just mentioned them in the CLD and CND group. Feedback welcome, as always.
Frailty Scale
This will be of interest to BC users as a result of the new fee codes introduced April 1 - which allows for a single entity - "frailty" - to qualify for complex care billing. This will be a significant item for those looking after frail elderly patients. First introduced by JohnR as a non-background e-form, I've just added the reference background. Requires some measurement set up for tracking purposes. JohnY
JPOCSC Primary Care Referral zip file
Created by Jan Nusche
Ridge Meadows Maternity Clinic-eForm
updated by Herb Chang
David Wilkie Referral 2013
Updated referral form for David Wilkie - Urogynecologist in Vancouver - <!--- Created May 2013, Written for version 12.0, Uses JSMPC.css to show the image while editing, uses X Box for check boxes, uses span for Yes and No boxes and Allergies and Medications, uses set defaults for english yes and assist no, uses on blur to fill out subject line when indication for referral is checked--->
BC Cytology Review
<!--- Created May 2013, Written for version 12.0, Uses JSMPC.css to show the image while editing, uses X Box for check boxes, uses tables and span for most text input, eform magic template used to send message to front desk, uses on blur to fill out subject line when Reason for Request is filled out and you move to the next box--->
Speech and Language Referral
Speech and Language referral - Fraser Health --- Hi JohnY, I have updated your form to add a drop down list of the Health Units and address/phone/fax numbers. Uses the same image Herb.
PCRM MFM Referral 2013
<!--- Created June 2013 by John Robertson, Written for version 12, Has x boxes, fills in subject line, ---> I have also included the colour png if people would prefer. You will need to change the line in the html that refers to the image.
RCH Student Rehab Clinic
This one's for docs in Fraser North, in the Royal Columbian Hospital catchment area. There is an outpatient rehab clinic that his hospital funded, and able to accommodate some patients who would be good teaching subjects for new OT/PT and even Med students (year 4). All treatment is supervised by excellent, licensed preceptors. Although it is not stated, WCB and ICBC cases are not accepted. JohnY
Updated generic Imaging Req - for New Westminster area HTML Only Ver 2
Update: Sorry, JohnR. After Dr. Boxer asked me to take another look at things, I found an incomplete task - MedRay update was not finished. This should be the "final" version. If others are trying this, please let me know if the PHN is not autopopulating. JohnY ---- This is for docs in the New West area - it is a backgroundless, "generic" imaging req with the quick-pick menu lifted from the hospital form. CML has bought up a bunch of existing clinics, and changed their scope of services somewhat. Some of the hours at Brooke have expanded, and others have contracted. Not able to find much on Brooke on the web, but fortunately, all the needed details available on (shhhhh…) Pathways. JohnY
Pacific Orthopaedic Rapid Access Clinic
Provided to me by Patti Rodger Kirkpatrick. Has a North Vancouver Address and has the "Seal" of the North Vancouver Division of Family Practice on it. JohnR.
Thanks to Mike Thompson and the Eighth Avenue Family & Maternity Care clinic in Vancouver - - - These eForms were commissioned by Eighth Avenue Family & Maternity Care in Vancouver, and they wanted to be sure to have them shared with the community. Booking form for the Induction of labour at BC Women's Hospital
Thanks to Mike Thompson and the Eighth Avenue Family & Maternity Care clinic in Vancouver - - - These eForms were commissioned by Eighth Avenue Family & Maternity Care in Vancouver, and they wanted to be sure to have them shared with the community.
Thanks to Mike Thompson and the Eighth Avenue Family & Maternity Care clinic in Vancouver - - - These eForms were commissioned by Eighth Avenue Family & Maternity Care in Vancouver, and they wanted to be sure to have them shared with the community.
Ultrasound-PHC-VCH Providence Health, St. Pauls, Mt. St. Joseph's
Thanks to Mike Thompson and the Eighth Avenue Family & Maternity Care clinic in Vancouver - - - These eForms were commissioned by Eighth Avenue Family & Maternity Care in Vancouver, and they wanted to be sure to have them shared with the community. Providence Health, St. Pauls, Mt. St. Joseph's
NB - this is the general referral form. The Prenatal Medical Genetics form is stored with the BCWH eforms. Provided by OSCARprn Referral to the Medical Genetics Clinic at BC Women's Hospital
Updated Low Back Pain Advisor March 20, 2014
March 2014 update: From JohnY : various typos and bugs in the original LBP advisor template have been corrected. Here is the latest version - zipped. See below for further details about the large zip file. If you install the update over the previous version, the warning about LowBackPain.js, DHTMLmain.js, and the other *.png files already existing in the image library can be safely ignored. Just ensure the eForm file is LBP17.html, and all should be fine. From JohnY Preamble: Here is the Low Back Pain Advisor. There are multiple zip files that need to be imported separately. First, unzip the main file to see the individual zips. Further instructions are in the ReadMeFirst.pdf file. Some of the eForms may already exist in your system. The enclosed eForms have all been recently updated and some have push/pull to measurement functionality. Setting up measurements will require assistance from OSP - primarily for the PHQ-9 and GAD-7 form. The LBP Advisor Tool was created in conjunction with PSP in preparation for the PSP MSK module which rolls out in 2014. Thanks, JohnY
Best Birth Clinic
Original Supplied by Kat Montgomery - Thanks! Further development by JohnY --- The main goal was to keep all the html "in house" - so I've used the internal calendar feature built into Oscar. Thanks to JohnR and others who used this previously in the anticoagulation bridging form, and probably other forms. You will recognize this from all the other calendars within Oscar. The end result is the form loads up way faster. Only one downside - you can't run this form fully outside of Oscar. Maybe a good reason to get Oscar over another EMR? ------Update------After JohnR's request to see X-boxes act like radio buttons, here is the version with the X-radio buttons. So if you must have the latest version….. JohnY JohnY
Colonoscopy Referral Form - Colon Screening Program
<!------Created Month/Year by Alex of OscarWest on 2013-11-19...... Modified by Herb Chang to check gender automatically ; add Ordering physician and MSP number Modified by John Yap to push/pull FIT result. Requires adding FIT to measurements and creating new LOINC code 58453-2 Occult Blood Immunochemical and mapping to FIT ---> It works. As long as you have set up the measurements properly. Create a new measurement, FIT, as below: If you don’t already have 58453-2 Occult Blood Immunochemical mapped in your system, then you have to create it. It’s under Admin/Customize oscarMeasurements/add measurement mapping. Click on “Add New Loinc Code” Add the code and Name. Click “Add Loinc Code” again. Almost there….. Now get to “View Mapping”. Search for code 58453-2. In my example, I’ve already mapped it, so FIT is mapped to the new LOINc code. However, if it not yet connected, it will have the map hyperlink in the left column. Click that link, and you will get another screen, from which you can select the measurement (i.e. FIT) to map to. JohnY
Standard Outpatient Lab Requisition ( SOPLR) November 2013
FP Maternity Service at BCWH referral form.
This is based on the FP Maternity Service referral form that is on line. That form is not formatted well, so I have used HTML for much of the form. Here is the comment. <!----- Created December 2013 by John Robertson. Copyright at bottom is to insure that the form is used as intended and is not commercialized, parses medical history and family history to add to text area without multiple entries. Mostly html form.--->
British Columbia Antenatal Record 2014 (BCAR 2014) Add ons
This is a collection of add ons ( eforms, js scripts, instruction pdfs etc) designed to enhance the BCAR 2014.
Canadian cancer Society information and support referral form BC and Yukon
To replace the previous version made December 2011 <!--- Updated January 2014, Written by Kevin Meyerink for version 12.0, Has x boxes and genderboxes, ---> Image is better than previous version.
Generic MRI Form and Patient Survey
Created By JohnY February 2014 - Some time ago, C Sedergreen posted something about yet another MR requisition, this time requiring patient screening questionnaire. I was able to find a good PDF of the screening questions, but not able to get the actual requisition itself. So I’ve modified the existing FHA MRI req (background actually NOT from FHA, it’s mine), and added the essentials to the older form. The screening questionnaire was not designed to submit, as the patient is required to fill it in and bring to MR clinic for review with the technologist at the time of scan. So it’s a print and give eForm. EForm in zip format for easy upload. Comments welcome. JohnY
VGH Diabetes Education Referral
From JohnY -- OK - I took a stab at it. I had to trim lots from the FHA form. Seems like FHA wanted a lot more detail, via preset checkboxes. Apologies to specialists using this form. It assumes that GP’s or other primary providers are making the referrals, hence no database pull to the Specialist field area. The background has been modified/enhanced for Oscar. > Of course, there are existing image files that will generate an error, but > the form itself did upload properly via the import function. One js file > that is used across many eForms is the JSMPC.css file. Unless someone > updates this file, there is no concern that an error is generated. As you > will see in the screenshot, the VGH_DEC_Pg1 and Pg2 files already exist (I > did not delete them from the image library, nor should any images be > deleted from the library) JohnY
Surrey Sleep Clinic
<!-- Created December 2012, Written for version 12.0, Has x boxes, checkgender, calendar select; updated Mar 2014 John Yap -->I was referring to the Surrey Respirologist a patient who need polysomnogram recently. They asked that I use their specific form - which they kindly faxed over. Before I attempted to make an eForm of it, I checked OCUS and found that KenM had already done so. It’s well done, but I found the background a bit fuzzy. Having found an original PDF, I went ahead and transferred the HTML over. Not able to leave good enough alone, I also rejigged the background so it aligned better, and trimmed the HTML significantly. There’s a lot of redundant code in some of my early X-box eForms which is a result of my crude cut/paste technique of programming! The best backgrounds, as per JohnR, are from original PDF’s that are edited with Adobe Photoshop, then “saved for the web”, which compresses the image significantly, without any noticeable loss of resolution. Compare with the older background, and you can decide for yourself. JohnY
Canadian cancer Society information and support referral form BC and Yukon
Submitted by Keven Meyerink.
Notification of Expected Death in the Home
Supplied by NERD BC and the Colebrook Family Practice The BC Ministry of Health Notification of expected death at home form. Updated for Pathways Sep26_2017, JohnY
Review of Prevention Module with Start and End Dates
Provided by OSCARWest - This report by template has been created to review the preventions module between two dates. User is required to input the prevention name from OSCAR and a start and finish date range. Helpful for clinics with annual reports to Health Authority and Ministry of Health.
Chronic Pain Management eForms
The following zip files make up the suite of eForms used in BC's upcoming PSP on managing chronic non-cancer pain. Some of the eForms may already exist, but many have been updated. Instructions to import new eForms and update existing eForms included. There is active development as the PSP content is evolving and pilot trials are yet to occur. Comments welcome. John Yap. Please use the latest version of the Chronic Pain Template - either V26_Oct14_2017, or the Chilliwack version.
VGH Women's Clinic
Please see the introductory note --- excerpt follows --- The V.G.H. Women’s Clinic is an umbrella to several different clinics: 1. COLPOSCOPY CLINIC 2. GYNE. ONCOLOGY/COMPLEX GYNECOLOGY CLINIC 3. VULVAR DISEASE CLINIC 4. MULTIDISCIPLINARY VULVODYNIA PROGRAM
BC Child Care Subsidy Application eform
From Chris Sedergreen: Attached herewith: BC Child Care Subsidy Application eform with PDF original and PNG image Chris.
Community Medical Imaging June 2014
This is an update of the XR req I use for the local (non-hospital) imaging clinics. It is backgroundless. So when WestCoast Medical Imaging announced, today, that they had extended hours, it was (relatively) easy to change all the dates. ..... The form can be easily manipulated for your locale. OK - relatively easy! JohnY
HIV drug request and enrolment forms
update 2021-Feb-17 19:09 PrEP Refill Prescriptions. Upgraded with signature stamp. The default STI site is the HIM clinic in New Westminster. Now there is the GP site option - which pastes the user's contact info. This info, along with pick-up site, etc, is retained for future eFORM loads. There is also a "REFILL NOW" option for those patients who wait until the last minute! Update 2018 - PReP HIV forms have been updated. Please use the 2018 forms. For BC Users, who are managing HIV patients - BCcFE for HIV/AIDS have updated their forms. cFE = centre for Excellence, or as Jel puts it - a ?silo?. Comments welcome. Measurements required for the Prescription form. The eForm names must be exactly as they are imported. Otherwise you will need to customize the html. JohnY
Gillian C. de Ganns Dermatitis referral form
Form for referral to Dr. de Ganns
PHSA Tumour Marker requisition
From David Marceniuk : I don't know if there is a PHSA tumour marker req already out there, I couldn't find one so I have developed my own using the eform generator. I attached it here. I don't know how to make circles so just type a capital O or a 0 for the test you want. Also I have my contact information preset in the fields so you will have to change that for yourselves. David Marceniuk NP(F) Tla'Amin Primary Care
Chinatown (Vancouver) Imaging form
Provided by Kat Montgomery. Uses extra css an js files which are in this folder (all should be zipped in the zipped version). Uses a slightly different calendar, and print functions.
Grieg and Associates Ultrasound referral
Form provided by Kat Montgomery, for Obstetrical ultrasounds at the Victoria Drive Clinic in Vancouver.
North Shore Medical Imaging Requisition
This form was provided by Kat Montgomery August 2014. I have tweaked it slightly to make it more generic. Presently it does not have the drawing code for the mammography. For some reason I was getting a server error when I added the code. JohnR.
Ultrasound Requsition for Brooke Radiology
Provided By Kat Montgomery
Embryopathology Requisition
For those who have an SAB at home but want pathology analysis.
Generic Outpatient Imaging Req: Lower Mainland 2021
Updated 2020 - COVID edition. Some sites have changed their operating hours and services. Some sites have closed temporarily. There have been major upgrades to this eFORM, especially for calculating OBS related US dates. If there are any errors, please notify JohnY. You may adapt as needed for your location. For May2021 - the print-submit function has been removed as more users migrate to Chrome; and even FF may lost that 2-step functionality. Plus - COVID has changed the hours of operation and services offered at various sites.
The Lung Center Referral Form 2014
Provided by NERD BC and the Eight Avenue Clinic
DermMedica Referral Form
Updated April 14th 2016 - Form Provided by Craig Crippen - Referral form for his dermatology Clinic - Hello, we are a new clinic to oscar and are using oscarhost services. They referred me to you for uploading an eform for physicians to the website. Sincerely, Dr. Craig Crippen MD CCFP Dermatology SIFP Committee BC & AB Representative | The College of Family Physicians of Canada
Burrard ECG Services referral form
Provided by the eight avenue clinic and NERD BC
Brenda and David McLean Integrated Spine Clinic - aka VGH Spine Clinic
Provided by the eight avenue clinic and NERD BC; updated Oct23_2020, John Yap.
West Coast Medical Imaging
Forms supplied by Nerd BC and Oscar West
BC Medical Practice Access to Pharmanet agreement
Commissioned by the Colebrook Clinic and created by NERD BC. With thanks to both. Patient consent to access pharmanet.
Fraser Orthopedic Institute (FOI) referral forms for the New West/TriCities area
Created by Dr. John Yap - They are linked, and should be zipped - for naming purposes. Referral form and acknowledgement form.
Prenatal Genetic Screening Form for BC: updated Jun 2021
Updated by John Yap. The eForm should zip in now. Web links have been updated. If you have an older version, you'll have to archive, rename, or delete the existing eForm in order to zip in the new one. If not sure, ask your OSP for assistance. N.B. The background is the same from Feb2014. Updated once again to Version 11. Submit/Print functions detuned. Formatting improved. Weblinks updated.
BC Standard Outpatient Bone Densitometry Requisition November 2017
Updated By Khai Phan and John Yap; upgraded Oct2017 JohnY
Fraser Orthopedic Institute August 2015
Created by JohnY
West Coast Medical Imaging (WCMI) requsition Xray and Ultrasound August 2015 requisition
Updated to reflect a new address for one of their sites. Provided by OscarWest
BC Heart and Lung Labs referral eform
Referral form for BC Heart and Lung Labs Created by Mukaila (Muki) Olundegun
Patient letter for distribution prior to annual hypertension visit - BC Sept 2015
For those BC users interested, Dr. Balint Budai introduced the idea of a HTN “reminder letter” to be sent to patients to prepare them for the HTN incentive billing. His work flow was to send the letter to patients prior to billing the 14052 code. If others are interested,
AIM Private MRI Referral eForm
Created November 26th 2015 for the Newcombe House Family Practice. There is a link to the web site imbedded in the eform. There is a menu on the side to help read and respond to the safety check more easily. JohnR.
Downtown Radiology Nuchal Translucency Form Vancouver 2015
Created by NERD BC
Pacific Cardiac Services 2015
This form was created by NERD BC, and commissioned by Larry Bloom of SleepWorks Medical Inc.
Lifelabs Requisition BC 2016
Provided by Jen Miller
BC Community Liaison Record Newborn and Mother
February 8th update - I have added a second version. Version 2 automatically fills in duplicate information on pages 3 and 4. When using version 2 please fill the form out in order from page 1 to page 4. --- At the request of Winifred Angus I have made the Liaison Records for the Newborn and the Mother. This is a 4 page form with signatures on page 1 and 3. There is circling on page 2 and 4. There are also calculations that are done. There is code to change the current user field from lastname, firstname to firstname lastname. It is built to be used in the chart of the mother, as the PHN may not yet be available for the Baby. I plan to update this to transfer information from Page 1 to page 3 where duplication exists and all of the information on page 2 is duplicated on page 4, which I will address on a future update. Comments welcome. JohnR.
Burrard ECG services 2016
Created with the kind support of the Vancouver Division of Family Practice by OSCARprn
UBC Outpatient Swallowing Clinic 2016
Created with the kind support of the Vancouver Division of Family Practice by OSCARprn
Custom Sleep Care Referral Form 2016
This referral form (For Custom Sleep Care) was sent to me by Eric Cheng "Attached you will find the .pdf and .docx versions of the referral form. We are working on a mobile app, but it will likely be summer when that is ready." --- This form was created with a link to their web page, a link to email them, and a "circle" (actually square) function for the male/female selection. JohnR.
DNR form BC 2016
Updated for 2016. Now it has signature, though I doubt pt will want to sign on our computers. Background is cleaner. Has links to other eForms used in End Of Life (EOL). Hidden web links. Etc. Comments welcome. JohnY
Surrey Sleep Clinic and Laboratory August 2018
Referral form by Dr. Minhas, updated in 2018.
BC NIPT Dynacare (Harmony) Requisition 2016
From Herb Chang and John Yap - There were changes to the NIPT funding in BC so that Dynacare is the sole funded provider. There was a new (Harmony) requisition form provided in Feb 2016.

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