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Wound Care
[…] at home or in a community nursing clinic. This includes assessing and diagnosing wound type(s), determining patient needs while considering other factors that affect wound healing, in order to develop a customized care plan to support wound management and best treatment options for healing, and improved quality of life and any appropriate self-management techniques. […]
Long-Term Care Home Short-Stay Respite Choice List
Please select up to five long-term care homes for short stay respite, including any out-of-Champlain choices, and rank them in order of your preference. The applicant’s name will be added to the wait lists for the chosen homes if eligible, and if the chosen long-term care homes can provide the required care. Ontario Health […]
Long-Term Care Home Short Stay Interim Choice List
Please select up to five long-term care homes for short stay interim and rank them in order of your preference. The applicant’s name will be added to the wait listsfor the chosen homesif eligible, and if the chosen long-term care homes can provide the required care. Ontario Health atHome will notify you about the […]
Palliative Care Common Referral Form FAQ
[…] in use by palliative care organizations across the City of Toronto since 2004. The PC-CRF was originally developed by the Toronto In-Patient Palliative Care subcommittee of the Toronto Palliative Care Network (now known as the Toronto Central Palliative Care Network) in order to standardize the application process to access palliative care services throughout the city.
Ceftriaxone Protocol Medical Referral Form – EN
To order the administration of ceftriaxone to patients being discharged from the Brantford Community Healthcare System (BCHS)
North East Speech Language Pathology
Being able to communicate your needs, or just to reach out to another person, is something we all value. If your ability to speak or swallow has been affected by a stroke or other illness, a Speech Language Pathologist may be able to help bring you back into the conversation.
First Dose – IV Medications Form – EN
To order first dose IV medications to be administered to patients in the community. First dose requests may take longer to process and are not appropriate for urgent requirements.
Iron Infusion Order Form
[…] 001 medical information attention physicians hnhb service providers able infuse pregnant women ildren iron policies procedures patient contact name contact phone weight kgs primary diagnosis drug allergies order urgency тшр within next days тшр weeks тшр weeks тшр please spe cify iron therapy administered hospital recent iron product given hospital date applicable values monitored […]
Vancomycin Aminoglycoside Prescription Form
To order IV vancomycin and/or aminoglycosides for patients in the community
Midline Catheter Form – EN
To order midline catheter maintenance
Referral and Treatment Form – Pain Medication
Referral and treatment plan pain medication order form – fillable
Providers Cupboard Usage – EN
Providers cupboard usage order form – fillable