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Medical Referral Form Adult

MAID Referral

[…] 2 DH WALKER OFFLOADING DEVICE – Eligibility Checklist Note: This form must be completed by the WCS and submitted for approval along with the Non-Formulary Medical Supply Order Form, via HPG to ESC SUPPLY ( Limit 1 x only DH Walker per patient ) Patient Name: _________________________________________ BRN#: ___________________ Date: _______________________ Depot requested: ___________________________________ […]

Electrical Stimulation (eSTIM ) Non‐Formulary  Order Form REQUESTED DEPOT  FOR SUPPLY DELIVERY: PATIENT INFORMATION  NAME:  BRN:  PHONE:  ADDRESS:  ORDERED BY:  CONTACT #:  ORDER  PRODUCT DESCRIPTION  McNIECE  PRODUCT CODE  CHRIS CODE  GV350 HV Rental Unit  R1862  GV350 RED Lead Wire for Rental (ea)  L2306 (Red)  GV350 BLACK Lead Wire for Rental (ea)  L2306 (Black)  Extender Wires for GV350  L2307  AA Batteries (ea) L6101  Lead Splitter (Y‐Cable)  L2401  Pin to Snap Connector (for garment)  L2400  ELECTRODES  Valutrode Foam 2″ x 2″ (pk/4)  L5135  Valutrode Foam 2″ x 3.5″ rectangle (pk/4)  L5138  Valutrode Foam 2″ x 4″ oval (pk/4)  L5139  Valutrode Fabric 2″ x 3.5″ rectangle (pk/4)  L5213  Valutrode Fabric 2″ x 4″ oval (pk/4)  L5214  Galvanic Dispersive Electrode 4″x7″ (1/pk)  L5216  GARMENTS  Silver Therastocking Small  Up to size 6 shoe and 35 cm calf  L5410  Silver Therastocking Medium  Shoe size 6‐11 and up to 38 cm calf  L5410  Silver Therastocking Large  Shoe size 11‐13 and up to 41 cm calf  […]

[…] Clare McCabe, Karyn Lumsden, Daryl Nancekivell , Jamie Stevens, Richlyn Lorimer, Robert Delvecchio, Karen Taillefer , Sarah Vertlieb , Cindy Ward Convening the Meeting A.1. Call to Order A quorum was present and the meeting was called to order a t 1 : 25 p m . A. 2 Land Acknowledgement The Board Chair […]

[…] • Take an active approach to recruitment by sharing engagement opportun ities in a  variety of ways • Explain how engagement is diferent from our complaints process and experi ence  surveys. • Meeting patients, families, caregivers and key partners in their ow n communities. Community Engagement Framework | 6 Relationship Building • Establish trust with patients, families, caregivers and create a safe en vironment so they  feel comfortable sharing their experiences and perspectives. • Tailor engagement opportunities to match the specifc skills, expertise a nd experiences  of each Advisor. • Listen to the ongoing needs of Advisors in  order to adjust processes and shift cu lture  over time. Communication • Ensure background, necessary information, and questions for input a re provided in  advance. • Focus on the qualities and skills of two-way communication, active liste ning and  empathy to receive and translate insights into realistic improvemen t opportunities. Clarity of Purpose • Manage expectations by providing clear guidance on the purpose of the program,  service or policy being discussed, why engagement is being done and what we hope to  accomplish. • Defne expectations in advance to ensure patients, families, caregivers a re clear on their  roles. • Share timelines for the broader initiative and where the engagement fts i n. Training and Coaching • […]

[…] Cacciotti, Josephine Kim, Odelia Andrea , Clare McCabe, Anthony DiCaita, Cathy Kelly, Tini Le, Karyn Lumsden, Karen Taillefer, Daryl Nancekivell A. Convening the Meeting A.1. Call to Order A quorum was present and the meeting was called to order at 1:24pm. A. 2 Land Acknowledgement The Board Chair shared a land acknowledgment. A. 3 […]

[…] program materials, as w ell as on the Home and Community Care Support Services website and social media platforms. 3. If I’m not able to complete the online submission form, is there another way I can submit the form? Those who are unable to use the online submission form can call us toll -free […]

The fundamentals of hospice palliative care Fall 2023 online classes Fundamentals core Fundamentals core education is a six -week certificate program for ALL health care providers and volunteers who wish to enhance knowledge and develop capacity related to hospice palliative care. Fundamentals eligibility • Health care provider or volunteer caring for people with a […]

[…] Partners John McGivney Children’s Centre Nutritional Management Services Limited ParaMed Inc. Saint Elizabeth Health Care The Hospice of Windsor and Essex County Inc. VHA Home HealthCare Victorian Order of Nurses (VON) Service Provider Organizations must provide services in French. The availability of bilingual staff may vary depending on the patient needs and health care. […]