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CHS-External-Referral-Form-March2021.pdf

CONNECT Mental Health General Support Services...Hearing Care Counselling Settlement Program for Newcomers...Referral for Employment: FAX: 1-855-259-8152 E-MAIL: employmentservices@chs.ca...Job...
https://www.southeasthealthline.ca/pdfs/CHS-External-Referral-Form-March2021.pdf

rac_lbp_patient_intake_form_march_2020.pdf

I have support from people who can assist me with activities in the home, work or community? ...(check one)... Strongly Agree  Agree  Neutral  Disagree  Strongly Disagree...PATIENT INTAKE...
https://www.southeasthealthline.ca/pdfs/rac_lbp_patient_intake_form_march_2020.pdf

“APPLICATION TO REGISTER” For Health Services

Number of people in one household who are supported by this income:___________________...Revised: August 2018 CL Application for Oral Health Program Page 2...HEALTH CARE...Do you have a family...
https://www.southeasthealthline.ca/pdfs/BQWCHC_application_referral_form_oral_Health_Services.pdf

lanark_county_community_paramedic_program_referral_form.pdf

Administrator...LCPS Community Paramedicine Referral...Date:...Client Profile/Notes to be sent to:...(Primary Care Provider Name & Contact Information including Fax – if applicable)...Patient Information
https://www.southeasthealthline.ca/pdfs/lanark_county_community_paramedic_program_referral_form.pdf

lanark_county_community_paramedic_program_clinical_guidelines.pdf

JScott...Lanark County Paramedic Service Telephone: (613) 205-1021...84 Lorne Street Facsimile: (613) 205-1016...Smiths Falls, Ontario Email: jsteele@lcps.care...K7A 3K8...The Community Paramedic Program...
https://www.southeasthealthline.ca/pdfs/lanark_county_community_paramedic_program_clinical_guidelines.pdf

kingston-youth-transitions-application

The Kingston Youth Shelter is proud to be a United Way Member Agency...Charitable Registration Number: 870659224RR0001...Kingston Youth Transitions Application for Residency...Please complete the...
https://www.southeasthealthline.ca/pdfs/kingston-youth-transitions-application.pdf