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mh-ads-fact-sheet

Adult Day Programs provide fun, engaging activities in the community for people with physical or cognitive challenges, as well as those with Alzheimer’s disease and related dementias. There are 10 Adult Day Programs at 17 locations in the Home and Community Care Support Services Mississauga Halton region. Check out our brochure to see a […]

Palliative patient status update form

Palliative patient status update form

IV First Dose and Iron Sucrose Screener_SW LHIN

= South West LHIN First Dose IV & Iron Sucrose in Community Screener Last Updated: 201 9-10 -21 Page 1 IV Administration Screener: First Dose IV & Iron Sucrose. To be completed & sent along with “IV Antibiotic Referral Form” or appropriate prescription Patient Name: ______________________________________________ HCN: ______________________________DOB:___________________ Address:___________________________________________________ Phone: ___________________________ Cell: ____________________ Medication […]

IV First Dose and Iron Sucrose Screener_SW LHIN

= South West LHIN First Dose IV & Iron Sucrose in Community Screener Last Updated: 201 9-10 -21 Page 1 IV Administration Screener: First Dose IV & Iron Sucrose. To be completed & sent along with “IV Antibiotic Referral Form” or appropriate prescription Patient Name: ______________________________________________ HCN: ______________________________DOB:___________________ Address:___________________________________________________ Phone: ___________________________ Cell: ____________________ Medication […]

Enteral Feeding Form, Jan 2020

Enteral Feeding Form, Jan 2020

Diabetes Type 1 Request Treatment_Form

[…] TREATMENT ORDER FORM DIAGNOSIS : Type 1 Diabetes Pl anned Start Date : REASON FOR REFERRAL TO LHIN: Child/teen requires school support over the lunch hour with: in su lin administration blood glucose monitoring Tim ing: _______________________________________________________________________ Chil d/teen and family to return to Children’s Hospital for ongoing diabetes education and support. If que […]

Diabetes Type 1 Request Treatment_Form

[…] TREATMENT ORDER FORM DIAGNOSIS : Type 1 Diabetes Pl anned Start Date : REASON FOR REFERRAL TO LHIN: Child/teen requires school support over the lunch hour with: in su lin administration blood glucose monitoring Tim ing: _______________________________________________________________________ Chil d/teen and family to return to Children’s Hospital for ongoing diabetes education and support. If que […]

Hydration_FORM

[…] Chloride x 1 L ☐ Other hydration solution:__________________________________________________________________ Total Vo lume: _________________________ Rate: ________ mL/hr Frequency : ___________ R oute: ☐ IV ☐ Subcutaneous D uration of In– Home Treatment: __________ Days OR _____________ Doses L ist ALL Drug Allergies: _________________________________________________________________ Special Instructions:____________________________________________________________________ __________________________________________________________________________________________________ Other Hydrations available include: Potassium Chloride 20 mE q.L in […]

HOOPP Beneficiary Designate Form

[…] hereby designate the person(s) and/or entity(s) set out above as my HOOPP beneficiary(s). I acknowledge that personal information on this form is being collected, used and maintained in order for HOOPP to provide pension services. I understand that personal information may be disclosed to third parties under contract with HOOPP to complete these services. […]

HOOPP Beneficiary Designate Form

[…] hereby designate the person(s) and/or entity(s) set out above as my HOOPP beneficiary(s). I acknowledge that personal information on this form is being collected, used and maintained in order for HOOPP to provide pension services. I understand that personal information may be disclosed to third parties under contract with HOOPP to complete these services. […]

CW-Central-Region-Temporary-Remote-Work-Policy

[…] to following expectations outlined b elow. Additionally, employees are responsible for maintaining a healthy and safe work environment by completing a Health & Safety Inspection Checklist (Referenced in the Health and Safety policy) on a monthly basis. Any areas that require attenti on, must be addressed by the Employee and reported to their Manager. […]

CW-Central-Region-Temporary-Remote-Work-Policy

[…] to following expectations outlined b elow. Additionally, employees are responsible for maintaining a healthy and safe work environment by completing a Health & Safety Inspection Checklist (Referenced in the Health and Safety policy) on a monthly basis. Any areas that require attenti on, must be addressed by the Employee and reported to their Manager. […]

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