---
title: 702 (01/21) - Patient Referral Form The Moncton Hospital Chest Clinic
slug: portal-sub/702-0121-patient-referral-form-the-moncton-hospital-chest-clinic
docTags: 
createdAt: 2026-03-04T12:03:23.527Z
---

702 (01/21) - Patient Referral Form The Moncton Hospital Chest Clinic

::Image[]{src="https://api.qa.archbee.co/api/optimize/zICxj0dnLereb6UUrBA3-/QQAjx_HW-WjLd-kNP56-Z_khhxd-9rwim4vcuccjsij-tmuzc97zbptw.png" size="78" isUploading="false" initialPath="assets/kHhxD-9RWiM4VCucCJSiJ-TmuzC97zbpTw.png" githubPath="fr/Formulaires/French NB/assets/kHhxD-9RWiM4VCucCJSiJ-TmuzC97zbpTw.png" position="flex-start" showCaption="false"}