September 2013 Dear shareholders and prospective shareholders, A key part of CRH Medical’s success is our practice support team. The team consists of four professionals based in our Vancouver, B.C. office who are responsible for working with customers to help integrate hemorrhoid banding into their respective practices. In September, senior management and the practice support team embarked on two initiatives that should support our long-term revenue growth. First, we launched a project to introduce new marketing support materials to our customers. The materials consist of:• Direct mailers that our clients can send out to patients advising that the practice can now treat them with the CRH O’Regan System.• A package to help trained practices draft and issue press releases informing patients on the availability of the O’Regan System at their centres. We think our GI partners will view these as two incrementally positive reasons to count on CRH Medical to an even greater degree to help them market the O’Regan System. Second, CRH management fine-tuned the overall model for the Company’s practice support team. Prior to September, we ran with a system where established customers had multiple touch points within the Company to help them meet their requirements. Now, we’ve assigned a member of our practice support team to handle all their needs – be it ordering, providing marketing or medical materials, or setting up secondary trainings. We think this model will allow the members of our practice support team to more effectively interact with customers by gaining a deeper knowledge of the operational aspects of their practices. From a client’s perspective, it’s a more streamlined system that involves working with one person who knows their business extremely well. Conferences in September During the second weekend of September, we attended the Georgia Surgical Society Annual Meeting in St. Simon’s Island, Georgia. This is the first time that we have exhibited at this meeting, which was attended by our Atlanta Clinical Support Specialist. We were able to gather a solid number of prospective client leads and initiate conversations with physicians who had yet to be introduced to the CRH O’Regan System. The following weekend, CRH attended Endofest in Las Vegas, which is run by the American Society for Gastrointestinal Endoscopy (ASGE). We have attended this meeting for the past several years because participation is typically strong, drawing in gastroenterologists from across the country. This past weekend, we also attended the Texas Society for Gastroenterology and Endoscopy Annual Program in Houston. This has also become a regular conference for CRH Medical as Texas is one of the states where we have the most trained physicians. At the conference, we were able to speak with physicians from across the state about the benefits of providing hemorrhoid treatment to their patients and provide suggestions on how existing groups can grow their practice. We also spoke with a number of GI fellows who were interested in having us come to their centre to speak on anorectal care. Fellowship Programs One way that we educate physicians about the O’Regan System is to train them early in their careers during their fellowship. Future gastroenterologists enter a GI Fellowship (typically 3 years) after completing their internal medicine residency which provides them with their subspecialty training in all aspects of gastroenterology. Fellows have recently started to demonstrate a significant amount of interest in learning more about treating perianal conditions, including hemorrhoids. We continue to expand our efforts to reach these physicians. Moving forward, it’s an area where we plan to focus more of our efforts on. Once educated, these gastroenterologists will be much more comfortable in introducing hemorrhoid treatment to their new practices once they’ve completed their fellowship. From a capital markets perspective, CRH’s liquidity continues to be strong – in September 2013, average daily volume on the TSX (58K) was more than double what it was in September 2012 (23K). We look forward to sharing the October 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 apeeler@tmxequicom.com