IV IRON REFERRAL

IV Iron is administered at Gravity Health Clinics

Please fill out the form below, whether you’re a doctor or a patient. Patients may self-refer.

IV Iron is administered at Gravity Health Clinics in Vancouver BC and Whitehorse, YK.

Please fill out the form below, whether you’re a doctor or a patient. Patients may self-refer.

IV Iron Infusion Referral Form

Patient's Name*

Email*

Contact No*

Date of Birth*

Sex
MaleFemalePrefer not to say/Other

Pregnant
YesNo

Known Allergies

Serum Ferritin < 100μg/L

If you do not have a ferritin test result from the last 3 months, please contact our office to book a 15-minute pre-iron consult first.

Fe-Saturation (TSAT) < 20% is indicative of iron deficiency under inflammatory conditions

Haemoglobin (may be normal in iron deficient patients)

Referring Clinic

Referring Doctor

Please specify any medical conditions

Attach copy of labs (< 3mo old)

IV IRON REFERRAL

IV Iron is administered at Gravity Health Clinics

IV Iron is administered at Gravity Health Clinics in Vancouver BC and Whitehorse, YK.

IV Iron Infusion Referral Form

Hi, we’re Bobby (Dr. Parmar) and Paul (Dr. Maximus).
We’re on a mission to eradicate iron deficiency via education and IV therapy.

Hi, we’re Bobby (Dr. Parmar) and Paul (Dr. Maximus).
We’re on a mission to eradicate iron deficiency via education and IV therapy.

Categories

Menu

Disclaimer

IV IRON REFERRAL

IV Iron is administered at Gravity Health Clinics

IV Iron is administered at Gravity Health Clinics in Vancouver BC and Whitehorse, YK.

IV Iron Infusion Referral Form

Hi, we’re Bobby (Dr. Parmar) and Paul (Dr. Maximus). We’re on a mission to eradicate iron deficiency via education and IV therapy.

Hi, we’re Bobby (Dr. Parmar) and Paul (Dr. Maximus). We’re on a mission to eradicate iron deficiency via education and IV therapy.

Categories

Menu

Disclaimer

Hi, we’re Bobby (Dr. Parmar) and Paul (Dr. Maximus).
We’re on a mission to eradicate iron deficiency via education and IV therapy.

Hi, we’re Bobby (Dr. Parmar) and Paul (Dr. Maximus).
We’re on a mission to eradicate iron deficiency via education and IV therapy.