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Doctor Examining Patient

Referral Kits for Physicians & Nurse Practitioners

LARC Referral Package

Dr. Manning is a Family Physician with GP focused practice designation in Obstetrics and Gynecology. 

Patients seen for gynecology consultations will not result in outside use penalties for referring physicians and nurse practitioners who belong to a FHO/FHT model. 


Dr. Manning has created the following Referral Package to support the counselling required to prescribe Long-Acting Reversible Contraception (LARC), including intrauterine contraception (IUDs) or the Etonogestrel Contraceptive Implant (Nexplanon). By providing your patient with this information and a prescription, you may refer your patient for single-visit access to the LARC insertion procedure.


(Download the fillable form)

If you are unable to provide the LARC counselling or would like Dr. Manning to provide a Birth Control consultation first, Dr. Manning is happy to see your patient during a birth control consultation as a separate visit.



Patients must also be referred for Pap Tests, Menopause Consultations, Menstrual Concerns, Post-Menopausal Bleeding & Endometrial Biopsy, Birth Control Consultations, PMS and PMDD, Medical Weight Management and Hormonal Acne. Please note, we do not see patients for breast health, vaginitis, prenatal care, or chronic pelvic pain.

* All referrals must include the patient's email address for booking.

(Download the fillable form)

General Women's Health Referrals

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