December 2014

Dear shareholders and prospective shareholders,

In early December, we announced the acquisition of Gastroenterology Anesthesia Associates, LLC, (GAA), one of the largest providers of anesthesiology services to gastroenterologists in the southeastern United States.

Gastrointestinal endoscopy procedures are highly reliant upon anesthesia services from third-party anesthesia providers, such as GAA. With the acquisition of GAA, CRH Medical further aligns itself with gastrointestinal physician specialists that either are – or could be – users of CRH’s current business.

GAA recorded more than US$25 million in revenue and US$16 million in EBITDA for the 12 months ending June 2014. CRH Medical paid US$58.6 million for GAA with up to an additional US$14.6 million payable within four-and-a-half years based on agreed financial performance requirements of the acquired business.

Integration of GAA

Since the acquisition closed, we’ve focussed on integrating GAA into CRH Medical. We spent much of December reaching out to GAA’s customers to let them know that they will get the same quality service going forward as GAA becomes a key part of our business. As we move ahead with the full integration, we anticipate that it will continue to be a seamless, straightforward process.

Talking to the Street about the Deal

Over the past month, we’ve spent a significant amount of time talking to current and prospective shareholders about the transaction. The acquisition has generated a lot of excitement in that it materially strengthens our pro forma revenue and EBITDA.

In addition, many of those who we’ve had meetings with have expressed enthusiasm about the broader opportunity for consolidation in anesthesiology service business for gastroenterologists. It’s a sentiment that we share and we intend to actively explore those opportunities as we work through the GAA integration.

Spreading the Word about the O’Regan System

While we are obviously excited about the GAA acquisition, the O’Regan System remains a steady, high margin asset for the Company.

Last month, we raised the O’Regan System’s profile by attending the annual New York Course hosted by the New York Society for Gastrointestinal Endoscopy. This meeting, which brings together GIs from across New York and many of the surrounding states, is well attended and a good opportunity for us to speak with prospective physician clients.

This year, it allowed us to interact with a particularly high number of trained physicians, many of whom indicated how pleased they were with procedure after achieving outstanding clinical results for their patients. We’re looking forward to attending many more conferences in 2015 to continue spreading the word about the CRH O’Regan System.

We look forward to sharing the January edition of the CRH Investor Bulletin with you, and as always, we appreciate your interest and support.

Adam Peeler
Media and Investor Relations
TMX Equicom
416.815.0700 x 225

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