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Short Stay Respite   Package   Page 2 of 2 TABLE OF CONTENTS    Short Stay Respite Information Sheet…………………………………………………..………………………………………………….3  Short Stay Respite Home Choice Sheet…………………………………………………………………………….………………………5  Long‐Term Care Accommodation Rates (English)………………….……………………………………………………..………….6  Long‐Term Care Accommodation Rates (French)……………………………………………………..………………………………8  Application for Determination of Eligibility for LTCH Admission Form (English)………………………….……………10  Application for Determination of Eligibility for LTCH Admission Form (French)….……..…………………………….11  Rights Information Sheet (English)………………………………….……………………………………………………………………12  Rights  Information Sheet (French)……………………………………………………………………………..………………………….13                          Stay Respite (SSR) Program‐Information Sheet   Etobicoke Office  Mississauga Office  Milton Office 401 The West Mall, Suite 1001 2655 North Sheridan Way, Suite 140 611 Holly Ave, Unit 203 Etobicoke ON, M9C 5J5 Mississauga ON, L5K 2P8 […]

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 – […]

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 – […]

[…] 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 […]

[…] 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 […]

Last Updated: 2022-0 9-23 Page 1 Enteral Feed Order Form Section 1: Patient Demographics Name: Address: City: Postal Code: Date: BRN: Phone: Section 2: Tube Details Type of Tube: □Nasogastric □ Percutaneous Endoscopic Gastrostomy (PEG) □ Percutaneous Endoscopic Gastrojejunostomy (PEG-J) ☐ Jejunostomy Date of Insertion: Physician who inserted the Tube: Plan for Tube Replacement: Section […]

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 […]

[…] 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 : […]

Last Updated: 2022/09/23 Page 1 of 1 Palliative Patient Status UpdateNAME: ADDRESS: CASELOAD: HCN/BRN: DATE d/m/ y : ATTENTION: PPS %:_ Pain scale : /10 Current Pain Regime: Areas of Concern: Suggestion of Treatment Orders: Additional Information: SIGNATURE: DESIGNATION: AGENCY PHONE NUMBER: RESPONSE OR ORDERS Response Required:  YES  NOSouth West Home and Community […]

Last Updated: 2022/09/23 Page 1 of 1 Palliative Patient Status UpdateNAME: ADDRESS: CASELOAD: HCN/BRN: DATE d/m/ y : ATTENTION: PPS %:_ Pain scale : /10 Current Pain Regime: Areas of Concern: Suggestion of Treatment Orders: Additional Information: SIGNATURE: DESIGNATION: AGENCY PHONE NUMBER: RESPONSE OR ORDERS Response Required:  YES  NOSouth West Home and Community […]