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Symptom Response Kit Request Order Form – Chatham and Sarnia Only
Ontario Health atHome end of life SRK is intended to facilitate timely access to a range of medications to relieve a client’s symptoms in the home on an urgent basis; thereby; potentially avoiding an emergency department and/or acute care admission. Physician orders are indicated below and authorized (signed) by the most responsible physician (MRP). The nurse can only administer those medications in the kit that have valid signed orders noted on this order form.
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