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Referral Forms

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Referral Forms

Sport Medicine Physician/Physiotherapy Referral Form

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Orthopaedic Referral Form

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Treatment Protocols

Knee

High Tibial Oseotomy (HTO) Protocol

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Advanced High Tibial Osteomy

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Functional Testing Guidelines for ACL Reconstruction

Physiotherapy Following ACL Reconstruction Protocol

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Hip

Conservative Management for Femoroacetabular Impingement (FAI)

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Hip Arthoscopy Protocol for Femoroacetabular Impingement (FAI)

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Shoulder

Anterior Arthroscopic Stabilization

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Large Rotator Cuff Repair Protocol

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Small Rotator Cuff Repair Protocol

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Ankle

Achilles Tendon Rupture Accelerated Rehab Protocol

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Western University

3M Centre, 40 Lambton Dr, London, ON N6G 2V4, Canada
519 661 3011

Fanshawe College

Student Wellness Centre
Room J1004
1001 Fanshawe College Boulevard
London, ON N5Y 5R6
519 452 4230

South Clinic

3209 Wonderland Road South, London, ON, Canada
226 667 3338

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