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CHS-External-Referral-Form-March2021.pdf

1 /2...Referral Form...for External Agencies...I. ...REFERRAL DETAILS...The applicant or lawfully authorized substitute decision maker has consented to this referral....Date:...
https://www.southeasthealthline.ca/pdfs/CHS-External-Referral-Form-March2021.pdf

btc_bayfield_treatment_centres_referral_form.pdf

Todd Powell...Bayfield Treatment Centres Referral Form...Confidential Page 1 12/21/2020...Once completed, this referral may be sent to:...Kimberly Baldwin, Director of Service...kbaldwin@bayfield.net...#...
https://www.southeasthealthline.ca/pdfs/btc_bayfield_treatment_centres_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

“APPLICATION TO REGISTER” For Health Services

Do you have any conditions or diseases that have not been listed? ...If so please list:...Do you take Aspirin or any Blood thinners? ...______________________________________...Have you ever been...
https://www.southeasthealthline.ca/pdfs/BQWCHC_application_referral_form_oral_Health_Services.pdf