Amise Medical Services · Saint Lucia

Refer a Patient to Amise Medical Services

General & Endoscopic Surgery — led by Dr Dawit Daniel Kabiye, MD, DM

For urgent referrals requiring same-day review, please also call 1 (758) 284 0557 directly in addition to submitting this form.

Referrals are reviewed by our clinical team within one working day. You will receive a confirmation with the proposed appointment details.

Referring Provider

Doctor's full name *

Practice / Hospital *

Contact phone *

Contact email *

GMC / Medical registration number (optional)

Patient Information

Patient full name *

Date of birth *

Patient contact phone *

Patient email (optional)

NIC / Passport number (optional — for identification)

Referral Details

Appointment type

Priority

🟢 Routine referral — patient to be seen within 3 weeks.

Clinical reason / presenting complaint * (0/500)

Relevant investigations already done (optional)

Current medications relevant to referral (optional)

The patient has been informed of this referral and consents to their information being shared with Amise Medical Services.I confirm this referral is clinically appropriate and I am a registered healthcare provider acting in a professional capacity.

Amise Medical Services · Tapion Hospital: 1 (758) 284 0557 · Rodney Bay Office: 1 (758) 720 7111
This portal is for healthcare professionals only. Patient data is handled in accordance with Saint Lucia's data protection framework.

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