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PHYSICIAN REFERRALS

Dr. Sadaf Gardizi

Dr. SaDAF GARDIZI

Dr. Sadaf Gardizi offers an evidence-based, non-surgical approach to weight management. Her physician-led program is fully covered by OHIP and focuses on long-term health improvements through personalized care.

We welcome referrals for patients with:

Obesity or metabolic syndrome

Type 2 Diabetes with weight-related challenges

PCOS or hormone-related weight gain

Cardiovascular risk linked to excess weight

Postpartum weight retention

Weight management without surgery

Patients receive medical evaluation, goal setting, lifestyle support, and ongoing follow-up.

Please have your doctor to complete the form below.

Physicians: Any additional documents can be faxed to 416-259-0888.

A copy of this online form will be sent to us automatically.

Welcome to The Borough Health & Wellness!

Help Dr. Gardizi prepare for your visit by completing this short mandatory intake form.

First Name *

Last Name *

Date of birth *

Phone *

Email *

Full Address *

Preferred Pharmacy *

Health card number (including the last two letters): *

Emergency Contact Name *

Emergency Contact Phone *

Emergency Contact Email *

Which concerns are you looking discuss? *

I've tried dieting and exercise but can't lose weight

My doctor has recommended I lose weight for my health

I have Type 2 diabetes or prediabetes

I have PCOS or hormone-related weight gain

I'm struggling with weight after pregnancy

I have high blood pressure or cholesterol linked to my weight

I'm interested in GLP-1 medication (Ozempic, Wegovy, Mounjaro)

I'm already on a GLP-1 and need medical support and monitoring

I have obesity or metabolic syndrome

I want a medically supervised weight loss plan

Tell Us Anything Else *

I’m open to receiving supportive updates and information that can help me better understand my symptoms and the wellness options available to me. I can unsubscribe at any time. *

Yes

No

For clinic use only. Your responses are confidential and help our team at The Borough provide care that’s tailored to your wellness needs.

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THE BOROUGH HEALTH & WELLNESS

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Phone: 416- 259-8888

Email: [email protected]

Address: 114-408 Brown’s Line

Etobicoke, ON M8W 0C3

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