Healthcare Providers

As requisition content can periodically change, please check back regularly for the most up-to-date version.

Cardiology Requisitions

Echocardiogram Requisition (outpatient)
Electrocardiogram and Holter Monitor Requisition
Pacemaker Requisition Form - Request for Device Interrogation 

Diagnostic Imaging Requisitions

Bone Mineral Densitometry Requisition
Computerized Tomography Requisition
Diagnostic Imaging Requisition
Magnetic Resonance Imaging Requisition
MRI Appropriateness Checklist
Nuclear Medicine Requisition
Rectal MRI for Cancer Staging Clinical Information Record

Oncology Referral Forms

Oncology New Patient Referral Form
Breast Cancer
Colorectal Cancer
Urology Cancer

Ocean eReferrals 

Bluewater Health has begun using the Ocean eReferrals platform. Primary care providers can currently use the electronic referral system to request diagnostic imaging tests, pulmonary function tests and the Musculoskeletal Rapid Assessment Centre, and will receive notification of the appointment assigned to the patient. The system can accommodate instructions and attachments for the patient, and allows better appointment management for the hospital. Other benefits include integration with primary care providers’ Electronic Medical Record (EMR), enhanced notification of referral status and appointment and decreased need for follow-up. The platform will be expanded to other programs, with the hope to include all outpatient areas in the future. If your office has not yet had an opportunity to join the Ocean eReferral network please email

Peripherally Inserted Central Catheter Information and Referral Form 

PICC Line Letter to Practitioners - March 2022
Referral Form - Peripherally Inserted Central Catheter (PICC)

Rehabilitation Referral Forms

Community Reintegration Program, Rehabilitation Outpatient Services
Communications Disorders Referral Form for Speech-Language Pathology Services

Other Referral Forms

Eating Disorders Outreach Program Adult Referral Form
Eating Disorders Outreach Program Youth Referral Form
Fecal Immunochemical Test (FIT) Referral Form
Secondary Stroke Prevention Clinic Patient Referral Form
Specialized Geriatric Service Referral Form

Maps & Directions

Bluewater Health’s programs and services are distributed across two locations, Bluewater Health in Sarnia and Charlotte Eleanor Englehart Hospital of Bluewater Health in Petrolia. 

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Emergency Care

Bluewater Health’s Emergency Department (ED) provides safe, quality emergency nursing and medical care to patients.

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Mental Health & Addictions Help

If you or a loved one needs support with mental health or addictions.

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Compliments & Concerns

We are always looking for ways to improve, and welcome your questions, comments, suggestions and concerns. If you’re in hospital, please speak to the hospital staff.

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Locate a Patient

Find or contact a patient by telephone, email or e-card.

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