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mh-short-stay-respite-package
[…] short-stay resident I may withdraw this application at any time. Last Name , First Name of â Applicant or â Applicant’s Substitute Decision- Maker © Queen’s Pr in ter for On tario, 2017 Disponible en francais Signature of â Applicant or â Applicant’s Substitute Decision -Maker X Date (yyyy/mm/dd) Ministère des Soins de longue […]
HCCSS-SearchingforManualInvoicesinHPG-Job Aid. ocx
Searching for Manual Invoices in HPG OACCAC Education Team March 22.2010 Launch HPG Click on Invoice Entry Tab – Search Invoice Complete Search Invoice File Page Search Invoice File Details Click on Invoice File ID link Invoice List Generate Invoice File Report – GO Click Invoice Tab Click on Invoice # link Finish – […]
HCCSS-SearchingforManualInvoicesinHPG-Job Aid. ocx
Searching for Manual Invoices in HPG OACCAC Education Team March 22.2010 Launch HPG Click on Invoice Entry Tab – Search Invoice Complete Search Invoice File Page Search Invoice File Details Click on Invoice File ID link Invoice List Generate Invoice File Report – GO Click Invoice Tab Click on Invoice # link Finish – […]
HCCSS-HPG-SystemAccessAuthorization-MultipleUserAccountSetUp-12Oct4
[…] tab for Complex Care or CSSA/LTCH eReferrals Organization is associated with Multiple CCACs (please specify with * beside user name if user already has an existing account in HPG and if so, which CCAC(s)______________ CCAC Name Team Name USER NAME – First Name, Middle Initial, Last Name CCAC Employee EMAIL ADDRESS or Contact Information […]
HCCSS-HPG-SystemAccessAuthorization-MultipleUserAccountSetUp-12Oct4
[…] tab for Complex Care or CSSA/LTCH eReferrals Organization is associated with Multiple CCACs (please specify with * beside user name if user already has an existing account in HPG and if so, which CCAC(s)______________ CCAC Name Team Name USER NAME – First Name, Middle Initial, Last Name CCAC Employee EMAIL ADDRESS or Contact Information […]
Hydration_FORM
[…] x 1 L ☐ Other hydration solution:__________________________________________________________________ To tal Vo lume: _________________________ Rate: ________ mL/hr Frequency : ___________ R oute: ☐ IV ☐ Subcutaneous Dura tion of In– Home Treatment: __________ Days OR _____________ Doses List ALL Drug Allergies: _________________________________________________________________ Special Instructions:____________________________________________________________________ __________________________________________________________________________________________________ Other Hydrations available include: Potassium Chloride 20 mE q.L in Normal […]
Hydration_FORM
[…] x 1 L ☐ Other hydration solution:__________________________________________________________________ Tota l Vo lume: _________________________ Rate: ________ mL/hr Frequency : ___________ R oute: ☐ IV ☐ Subcutaneous Durati on of In– Home Treatment: __________ Days OR _____________ Doses List ALL D rug Allergies: _________________________________________________________________ Special Instructions:____________________________________________________________________ __________________________________________________________________________________________________ Other Hydrations available include: Potassium Chloride 20 mE q.L in […]
Enteral Feeding Form, Jan 2020
Enteral Feeding Form, Jan 2020
Diabetes Type 1 Request Treatment_Form
REQUEST AND TREATMENT ORDER FORM DIAGNOSIS : Type 1 Diabetes Plan ned Start Date : REASON FOR REFERRAL: Child/teen requires school support over the lunch hour with: in sulin administration blood glucose monitoring Timi ng: _______________________________________________________________________ Child /teen and family to return to Children’s Hospital for ongoing diabetes education and support. If ques tions […]
IV First Dose and Iron Sucrose Screener_SW LHIN
= First Dose IV & Iron Sucrose in Community Screener Last Updated: 2022-09-2 6 Page 1 of 1 IV Administration Screener: First Dose IV & I ron S ucrose. To be completed & sent along with “IV Antibiotic Re f erral Form” or appropriate prescription Patient Name: ______________________________________________ HCN: ______________________________DOB:___________________ Address:___________________________________________________ Phone: ___________________________ Cell: […]
NPWT Therapy Referral Information Sheet
[…] ï¨wound improving Wound measurements & des c ription: Length: cm x width: cm x Depth: cm Undermining : Tunnelling: Expected therapy goals : (i.e. Flap/Graft/Closure/Prep for Surgery) in wee ks. Without NPWT Therapy, how long would this/these wound(s) take to heal (approx.) weeks Indicate what the frequency would be for conventional dressing changes : […]
NPWT Therapy Referral Information Sheet
[…] ï¨wound improving Wound measurements & des c ription: Length: cm x width: cm x Depth: cm Undermining : Tunnelling: Expected therapy goals : (i.e. Flap/Graft/Closure/Prep for Surgery) in wee ks. Without NPWT Therapy, how long would this/these wound(s) take to heal (approx.) weeks Indicate what the frequency would be for conventional dressing changes : […]