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cen-telehomecare-referral-form-en
Note: The information contained in this form is confidential. It c ontains personal health information that is subject to the provisions of the ‘Personal Health Information Protection Act, 2004’. This form and its contents should not be distributed, copied or disclosed to any unauthorized persons. If you have accessed this form in error, please contact the owner or sender immediately. V 3.9 C O PD & H eart F ailure T elehom ecare R eferral F orm Pleas e fa x re fe rra l for ms(s ) to : PATIENT INFORMATION Referral Date ( D D MM YYYY) : ________________ LAST NAME F IRST NAME DATE OF BIRTH (DD MM YYYY) HEALTH CARD […]
nsm-medical-referral-form-child
[…] confidential. Any other delivery, distribution, copying or disc losure is strictly prohibited and is not a waiver of privilege or confidentiality. If you have received this telecommunication in e rror, please notify the sender immediately by telephone at 721 -8010 or 1 -888 -721 – 2222 so that arrangements can be made for its […]
nsm-medical-referral-form-child
[…] Any other delivery, distribution, copying or disc losure is strictly prohibited and is not a waiver of privilege or confidentia lity. If you have received this telecommunication in e rror, please notify the sender immediately by telephone at 721-8010 or 1-888-72 1- 2222 so that arrangements can be made for its destruction or return […]
cen-palliative-common-referral-form-en
[…] of 3 PATIENT INFORMATION Name: (Individubl’s Lbst Nbme, First Nbme) Home Address: (Street No., Street Nbme, Building) (Apt/Suite#) (Entry Code) City: Postal Code: Lives Albne Ybung Children in the Hbme Smbking in the Hbme Pet(s) in the Hbme (Specify): Hu.n sbuwn /R.-ng’ evyngw,yn /R.-ng’ Date of Birth: Gender: Male Faith/Religion: (dd -mmm -yyyy) Female […]
Request for Release of Personal Health Information – English
Ontario Health atHome, Request for Release of Personal Health Information
cen-intake-and-linking-referral-form-en
[…] Placement bursing butritional Services Occupational Therapy Personal Support (e.g. bathing, dressing) Physiotherapy Social Work Speech Lanuage Pathology Community Linking (e.g. housekeeping, shopping, transportation) Has the patient been in the ER/hospital within the last 14 days? Unknown bo Yes Does the patient have a current cancer diagnosis? Unknown bo Yes Has the patient had any […]
cen-intake-and-linking-referral-form-en
[…] Nursing Nutritional Services Occupational Therapy Personal Support (e.g. bathing, dressing) Physiotherapy Social Work Speech Lanuage Pathology Community Linking (e.g. housekeeping, shopping, tra nsportation) Has the patient been in the ER/hospital within the last 14 days? Unknown No Yes Does the patient have a current cancer diagnosis? Unknown No Yes Has the patient had any […]
cen-clinic-eligibility-en
Community Clinic Eligibility Criteria 18 June 2021 Page 1 of 1 Community Clinic vs. In-Home Nursing Eligibility Information to guide patient-focused decisions Clinic Eligibility With extended evening and weekend hours, and seven convenient locations to choose from, for most patients Ontario Health atHome community clinics are the best options to ensure high-quality, specialized nursing […]
cen-clinic-eligibility-en
Community Clinic Eligibility Criteria 18 June 2021 Page 1 of 1 Community Clinic vs. In-Home Nursing Eligibility Information to guide patient-focused decisions Clinic Eligibility With extended evening and weekend hours, and seven convenient locations to choose from, for most patients Ontario Health atHome community clinics are the best options to ensure high-quality, specialized nursing […]
cw-palliative-np-referral-form-EN
cw-palliative-np-referral-form-EN
cw-palliative-np-referral-form-EN
cw-palliative-np-referral-form-EN
OHaH-Long-Term-Care-Placement-Guide-EN
[…] Care Homes 5 2. Visit the homes you would like to consider Visiting homes or learning more about your top choices by visiting Ontario.ca/LongTermCare will help answer some of your questions. By taking a tour, you can get a better feel for the surroundings and the people who work and live in the home. When you visit a long-term care home, you may want to ask: z for an information package on the home z for copies of recent inspection reports – the province conducts regular inspections, as required under the Fixing Long-Term Care Act, 2021. You can also fnd the reports online at publicreporting.ltchomes.net z to speak to a member of the home’s Residents’ Council z to speak to a member of the home’s Family Council, if available Before touring the long-term care homes you are considering, list the features that are important to you and pre-book the visit so that you will be able to get an informative tour. Some things to consider for your list: z Location: Is the home close enough for family and friends to visit? z Cultural/language/religious preferences: Do these factors need to be considered? […]