General Referral Form
IUD/IUS Referral Form
Miscarriage Referral Form

At VIWC we see women who....

  • need a pap and sti screening and are between the ages of 25-69 
  • have a threatened, suspected or known miscarriage 
  • need endometrial biopsy, +/- Mirena insertion, for heavy menses 
  • have unplanned pregnancies
  • need birth control including IUD insertions 
  • have concerns about IUD

 

 We currently DO NOT see women who:

  • need or want a female GP
  • have menopausal concerns
  • have any other gynecolgical concerns

Referring a Patient....

For ease of sending referrals here are some forms for your use to fill out and fax to 250 480 7339. Please note that a Referral form must be sent for all services.