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1240 14th Avenue SW, Calgary AB

REFERRAL FORM
For Health Care Providers

The patient I am referring (or their partner) identifies as an Indigenous person. PLEASE NOTE: We are only accepting provider referrals for Indigenous patients at this time.

Please specify referral type

Low-Risk Perinatal Care - Our midwives offer full-scope continuity of care, and accept referrals from conception to six weeks postpartum depending on practice capacity.

Collaborative Perinatal Care - For patients with medical risk factors facing socioeconomic, geographic, or cultural barriers to perinatal obstetrical care.

Please select ways we may assist in reducing barriers and improving patient outcomes and experiences of perinatal care

Access to Indigenous Midwives.

24/7 access to a primary care provider by phone or text for urgent or non-urgent perinatal concerns, including pregnancy and infant loss support and care.

Additional supports for first-time, single or teenage expectant parents.

Home visits to overcome transportation and childcare barriers inlcuding: blood pressure assessment, blood draws, early loss support and monitoring, prenatal check-ups.

Community-based care in surrounding First Nations including: blood pressure assessment, blood draws, early loss support and monitoring, prenatal check-ups.

Breast/chest feeding and lactation support (in clinic, home, or First Nation community settings)

Additional supports for patients experiencing medical evacuation for birth from remote Indigenous communities.

Referral Details - PLEASE INCLUDE PROVIDER CONTACT INFORMATION

Thank you for your referral. We can also be reached by pager (587) 907-4545 for any urgent questions or concerns.