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Referral Forms

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Local Referral Forms


Clinic City Description Referral Form
Primary Care Obstetrical Clinic New Westminster Family physicians who provide maternity care and deliveries for their patients. All deliveries are performed at Royal Colombian Hospital. Physicians work together with the other members of the perinatal team at RCH. Clinic requires a referral and prefers referrals be sent as early as possible in pregnancy. Please ensure a dating ultrasound has been ordered. Click here
Port Moody Maternity Clinic (previously called CMC) Port Moody Family physicians who provide maternity care and deliveries for their patients. All deliveries are performed at Royal Colombian Hospital. Physicians work together with the other members of the perinatal team at RCH. Clinic requires a referral and prefers referrals be sent as early as possible in pregnancy. Please ensure a dating ultrasound has been ordered. Click here
Inlet Community Birth Program Port Moody We are a collaborative, interdisciplinary maternity care program for the community north of the Fraser (Burnaby, New Westminster, Coquitlam, Port Moody, Port Coquitlam, Pitt Meadows, and others who plan to give birth at Royal Columbian Hospital). We provide prenatal, intrapartum, and postpartum care to clients and their newborns from early pregnancy through to approximately six weeks postpartum. We also provide Connecting Pregnancy prenatal groups, home postpartum visits, and lactation support drop-in sessions. Click here
Tri-City Midwives Coquitlam Tri-City Midwives provides care for families in the Tri-Cities who are planning to deliver at Royal Columbian Hospital in New Westminster or at home in the Tri-Cities. This includes regular prenatal appointments, care throughout labour, delivery of the baby, and postpartum care for the mother and baby up to 6 weeks postpartum. Patients can self-refer for pregnancy and postpartum care. BC funded health coverage is a requirement. Click here
Hip Dysplasia Clinic - Royal Columbian Hospital New Westminster Developmental Dysplasia of the Hip (DDH) affects about 1 baby in a 100. The risk is higher in breech babies and female babies with a family history of DDH. Doctors and midwives examine hips for DDH at birth and during the first year of life. If risk factors are present, or hip examination suggests DDH might be present, babies can be referred to the Hip Dysplasia Clinic for a full evaluation (and to start treatment if necessary). Click here
 
 
 

Provider Resources


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BC Women’s Hospital Resources for Providers

BC Women’s Hospital offers many useful materials to support patient care including referral forms and professional resources.

Prenatal screening - blood tests & ultrasound

This site contains information regarding prenatal screening. As well, the routine care schedule has been summarized on Pathways.

 
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Perinatal Services BC Resources for Providers

Offers resources on culturally safe Indigenous care, breastfeeding, health promotion, screening and more.

 

Rourke Baby Record

The Rourke Baby Record (RBR) is an evidence-based health supervision guide for primary healthcare practitioners of children in the first five years of life.

The RBR contains guidelines and information for comprehensive well baby/child care including: growth and nutrition monitoring, developmental surveillance, physical examination parameters, immunizations, and anticipatory guidance on safety, family, behaviour and health promotion issues.

The Rourke Baby Record is endorsed by the Canadian Paediatric Society (CPS), the College of Family Physicians of Canada (CFPC), and Dietitians of Canada (DC).

 
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Pathways Pregnancy Care Resources

Follow this link to Pathways to find all pregnancy care related community and health authority services, physician resources, and patient handouts. Log-in required, contact fnw@pathwaysbc.ca for access.

Early Pregnancy Algorithm for Key Tasks

Find the algorithm on Pathways at this link, or type “Early Pregnancy Care Pathway” into the search bar.

 

RACE (Rapid Access to Consultative Expertise) Line

A phone line for primary care providers to access real-time telephone advice directly from a reproductive mental health psychiatrist. Calls are typically returned within 2 hours and commonly within an hour.

Monday - Friday 8:00 am – 5:00 pm (excluding statutory holidays)

604-696-2131 or 1-877-696-2131

 

LactMed Medication Database

A free, online database that contains information on drugs and chemicals to which breastfeeding mothers may be exposed to. This database is for both healthcare professionals and mothers. It includes information on the levels of such substances in breast milk and infant blood, and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate.

 

MotherToBaby Medication Information

Information about medications and other exposures during pregnancy and breastfeeding. This website is for both healthcare professionals and mothers. Includes fact sheets for over 250+ exposures.

 
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Maternity Care for B.C. - Supports for Family Physicians

Through funding and support from the GPSC, Maternity Care for BC (MC4BC) supports family doctors to strengthen their obstetrical knowledge and skills through hands-on experience, peer mentorship, and financial compensation.

Family physicians who intend to provide (or currently provide) maternity services, including antepartum, labour and delivery, postpartum, and/or breast-feeding care, are eligible to participate in MC4BC.

For more information email gpsc.MC4BC@doctorsofbc.ca

 

The Newborn and Mother Discharge Summary includes recommendations and guidelines for what to expect after discharge from the hospital. For patients of Royal Columbian Hospital. Developed by primary maternity care physicians, obstetrician-gynecologists and pediatricians.

Click here to view the resource.


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