Facebook Pixel Code
Metabolic Bone Health Unit

How to make a referral

How to make a referral

• Send your referral via  ARMs, our on-line Ambulatory Referral Management System or
• Fax a completed referral form (available in PDF format). View the clinical directory for fax numbers.
• Learn more about the ARM system.

We are seeing children who meet the following referral criteria.

Please note that full diagnostic work up is required for first clinic visit.

Priority 1

  • Chronic illness and vertebral compression fractures
  • Chronic illness and 2 or more non vertebral fractures
  • Well child with non traumatic vertebral compression fractures
  • Child with Osteogenesis Imperfecta and 2 or more non vertebral fractures a year and/or any vertebral compression fractures
  • Transplantation and BMD Z score < -1.5

Priority 2

  • Chronic illness and BMD Z score < -1.5
  • Child with Osteogensis Imperfecta without vertebral or non vertebral fractures
  • Child with Syndrome Associated Osteoporosis

If the child meets the above criteria, please refer to the osteoporosis clinic along with the completed results to fax # 416-813-6192 using the SickKids referral form (see above).

If the child does not meet the above criteria, see our suggestions for ongoing evaluation and management of Children's Bone Health.

Work up for required for first visit

Please complete the following diagnostic tests to assess whether the patient meets the referral criteria to the Osteoporosis Clinic.

Blood work

Calcium, Phosphate, PTH, alkaline phosphatase, 25(OH) Vitamin D, creatinine

Spot Urine

Calcium/creatinine ratio

Bone Mineral Density

SickKids is preferred because the equipment used provides a Z score, which is age and gender specific.
If an outside laboratory is used, please ensure that a Z score can be provided.

Thoracic Lumbar spine AP & Lat

To be ordered only if clinically indicated.
SickKids is preferred because of standardization of the procedure. If an outside radiological facility is used, please see attached details to give to the radiologist. These results are preferred in electronic form; otherwise please fax report to 416-813-6192 and send hardcopy with the family.