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TC-Referral-Form-EN
REFERRAL FORM FOR ONTARIO HEALTH ATHOME PLEASE FAX COMPLETED REFERRAL FORM TO ONTARIO HEALTH ATHOME 416 -506 -0374 *PLEASE PRINT CLEARLY* PATIENT INFORMATION FIRST NAME: VC DATE OF BIRTH: DD MM YYYY APT# ENTRY CODE: PROVINCE: ALTERNATE: POSTAL CODE: LAST NAME: HEALTH CARD # ADDRESS: CITY: PRIMARY TELEPHONE #: PREFERRED LANGUAGE: PRIMARY CONTACT INFORMATION FIRST […]
Referral-Form for Ontario Health atHome – English
REFERRAL FORM FOR ONTARIO HEALTH ATHOME PLEASE FAX COMPLETED REFERRAL FORM TO ONTARIO HEALTH ATHOME 416 -506 -0374 *PLEASE PRINT CLEARLY* PATIENT INFORMATION FIRST NAME: VC DATE OF BIRTH: DD MM YYYY APT# ENTRY CODE: PROVINCE: ALTERNATE: POSTAL CODE: LAST NAME: HEALTH CARD # ADDRESS: CITY: PRIMARY TELEPHONE #: PREFERRED LANGUAGE: PRIMARY CONTACT INFORMATION FIRST […]
tc-iv-remdesivir-referral-form-en
[…] June 28, 202 4 EMAIL COMPLETED FORM TO: COVIDCare@uhn.ca or fax 416- 340-4135 Referral form may not be processed if all sections are not completed. IMPORTANT: In order to qualify for start of treatment, patients need to a) Be within 7 days of sy mptom onset b) Meet criteria for use c) Be willing […]
tc-iv-remdesivir-referral-form-en
[…] June 28, 202 4 EMAIL COMPLETED FORM TO: COVIDCare@uhn.ca or fax 416- 340-4135 Referral form may not be processed if all sections are not completed. IMPORTANT: In order to qualify for start of treatment, patients need to a) Be within 7 days of sy mptom onset b) Meet criteria for use c) Be willing […]
tc-iv-remdesivir-referral-form-en
[…] June 28, 202 4 EMAIL COMPLETED FORM TO: COVIDCare@uhn.ca or fax 416- 340-4135 Referral form may not be processed if all sections are not completed. IMPORTANT: In order to qualify for start of treatment, patients need to a) Be within 7 days of sy mptom onset b) Meet criteria for use c) Be willing […]
tc-application-specialty-hospitals-form-en
[…] Any diagnosis of being deve lopmenta lly delayed? □ Yes □ No □ Yes □ No Is the Patient medically stable? Specify: Does patient have a DNR order? □ Yes □ No Any Advance Directives? □ Yes □ No Specify: Specify: List any outstanding medical appointments of the Patient: Other Medical Needs: IV Therapy […]
tc-application-specialty-hospitals-form-en
[…] Any diagnosis of being deve lopmenta lly delayed? □ Yes □ No □ Yes □ No Is the Patient medically stable? Specify: Does patient have a DNR order? □ Yes □ No Any Advance Directives? □ Yes □ No Specify: Specify: List any outstanding medical appointments of the Patient: Other Medical Needs: IV Therapy […]
tc-adult-slp-referral-form-en
[…] Physician / Nurse Practitioner Name: Address: Telephone number: Signature: Date: OHIP billing code: E LIGIBIL ITY FOR DI RECT SER VIC ES: Valid OHIP card Assessment by an Ontario Health atHome Health Care Professional Access is available 24 hours a day, 7 days a week, every day of the year June 28 20 24, […]
tc-adult-slp-referral-form-en
[…] Physician / Nurse Practitioner Name: Address: Telephone number: Signature: Date: OHIP billing code: E LIGIBIL ITY FOR DI RECT SER VIC ES: Valid OHIP card Assessment by an Ontario Health atHome Health Care Professional Access is available 24 hours a day, 7 days a week, every day of the year June 28 20 24, […]
cen-mhan-referral-form-en
[…] conbacb bhem ab bheir school. Section B – Sbudenb’s Consenb for Parenbs/Guardian bo be conbacbed: · The sbudenb conbrols who we are permibbed bo speak wibh, as such, bhe sbudenb musb provide bhe conbacb informabion for bhe individuals bhab bhe sbudenb has provided consenb for bhe menbal healbh and addicbions nurse bo conbacb. · […]
cen-mhan-referral-form-en
[…] conbacb bhem ab bheir school. Section B – Sbudenb’s Consenb for Parenbs/Guardian bo be conbacbed: · The sbudenb conbrols who we are permibbed bo speak wibh, as such, bhe sbudenb musb provide bhe conbacb informabion for bhe individuals bhab bhe sbudenb has provided consenb for bhe menbal healbh and addicbions nurse bo conbacb. · […]
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? […]