Central West area

Central West Area Office Locations

  • Brampton
    199 County Court Blvd.
    Brampton, ON, L6W 4P3

Compliments and Concerns?

Please share your feedback with your care coordinator. You may also share compliments or concerns in the following ways:

Email: cw.patient.relations@ontariohealthathome.ca

Phone: 905-796-0040 ext. 7107

Mail: Ontario Health atHome
c/o: Patient Relations
199 County Court Blvd,
Brampton, ON L6W 4P3

Newsroom and Media Relations

Visit our newsroom for more information on news and events. 

For all media-related enquiries, please contact media@ontariohealthathome.ca.

For non-media-related enquiries, please visit the Contact Us page to access additional contact information.

Forms

TitleSummaryRegionLast ModifiedCategoryFile TypeFile SizeLinkhf:doc_tagshf:doc_categorieshf:file_type
Application for School Health Support Services

Application for School Health Support Services for the PDSB, DPCDSB, UGDSB, YRDSB, YRCDSB, TDSB, TCDSB, and other school boards

June 28, 2024pdf156 KBcentral-westformspdf
Formulaire de demande pour la divulgation de renseignements personnels

Formulaire de demande pour la divulgation de renseignements personnels. En vertu de la Loi de 2004 sur la protection des renseignements personnels sur la santé Veuillez

, , , , , , , , , , , , , , September 19, 2024pdf229 KBcentral central-east central-west champlain erie-st-clair global hamilton-niagara-haldimand-brant mississauga-halton north-east north-simcoe-muskoka north-west south-east south-west toronto-central waterloo-wellingtonformspdf
Medical Referral Form – Community

Community Medical Referral Form – Central West

July 2, 2024pdf1 MBcentral-westformspdf
Medical Referral Form – Hospital – English

Central West – Hospital Medical Referral Form

June 28, 2024pdf1,020 KBcentral-westformspdf
Medical Supplies Order Form – Infusion and Enteral Supplies

Infusion and Enteral Supplies Order Form for Central West area

September 24, 2024, pdf326 KBcentral-westforms medical-equipment-and-suppliespdf
Medical Supplies Order Form – Ostomy

Ostomy Supply Order Form for Central West area

October 28, 2024, pdf249 KBcentral-westforms medical-equipment-and-suppliespdf
Medical Supplies Order Form – Respiratory Therapy

Respiratory Therapy Supply Order Form for Central West area

October 28, 2024, pdf250 KBcentral-westforms medical-equipment-and-suppliespdf
Medical Supplies Order Form – Urinary Continence

Urinary Continence Supply Order Form for Central West area

September 24, 2024, pdf313 KBcentral-westforms medical-equipment-and-suppliespdf
Medical Supplies Order Form – Wound Care and General

Wound Care and General Supply Order Form for Central West area

October 28, 2024, pdf313 KBcentral-westforms medical-equipment-and-suppliespdf
MHAN Referral Form (English)

Mental Health and Addictions Nursing Program Referral Form

June 28, 2024pdf245 KBcentral-westformspdf
Negative Pressure Wound Therapy Referral Form

Note: NPWT will continue to be assessed in the community, and settings may be reviewed based on exudate and patient tolerance. Continuation of NPWT is dependent on wound healing goals being met. Maximum treatment time for NPWT is 8 weeks.

September 10, 2024pdf515 KBcentral-westformspdf
Negative Pressure Wound Therapy Supplies and Equipment Order Form

Order form for supplies and equipment needed for Negative Pressure Wound Therapy in the Central West area

September 10, 2024pdf597 KBcentral-westformspdf
Palliative NP Referral Form

Central West Palliative Nurse Practitioner Referral Form

June 28, 2024pdf282 KBcentral-westformspdf
Request for Release of Personal Health Information

Request for Release of Personal Health Information under the Personal Health Information Protection Act, 2004

, , , , , , , , , , , , , , September 19, 2024pdf2 MBcentral central-east central-west champlain erie-st-clair global hamilton-niagara-haldimand-brant mississauga-halton north-east north-simcoe-muskoka north-west south-east south-west toronto-central waterloo-wellingtonformspdf
Symptom Management Kit Form

Prescription form for Symptom Management Kit

June 28, 2024pdf287 KBcentral-westformspdf