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New Client Application Form - Sept 2023 -FINAL.pdf

Do you have any chronic diseases, or is there anything you would...like us to know about your health?...No Yes – Please explain below...Have you had a hard time receiving health services and...
https://www.southeasthealthline.ca/pdfs/New%20Client%20Application%20Form%20-%20Sept%202023%20-FINAL.pdf

Client Onboarding Document

Amanda...Welcome...Guide...Picton, ON K0K 2T0...40 Downes Ave...info@hospicepe.com...613-645-4040...We are very honoured to support our residents and their families...during this time. ...We have...
https://www.southeasthealthline.ca/pdfs/Hospice%20Guide.pdf

400292 Initial Assessment ABI OT

barkerd...400127 (2019/02) SIDE 1 OF 1 PERSONAL HEALTH INFORMATION RECORD FORM...P...E...R...S...O...N...L...H...E...L...T...H...N...F...O...R...M...T...IO...N... Physiotherapy  Occupational Therapy
https://www.southeasthealthline.ca/pdfs/pc-Rehabilitation-Therapy-Centre-Outpatient-Referral-2019-02.pdf

400292 Initial Assessment ABI OT

barkerd...400127 (2019/02) SIDE 1 OF 1 PERSONAL HEALTH INFORMATION RECORD FORM...P...E...R...S...O...N...L...H...E...L...T...H...N...F...O...R...M...T...IO...N... Physiotherapy  Occupational Therapy
https://www.southeasthealthline.ca/pdfs/pc_referral_form_seniors_day_rehabilitation_accident_recovery_centre.pdf

400292 Initial Assessment ABI OT

barkerd...400127 (2019/06) SIDE 1 OF 1 PERSONAL HEALTH INFORMATION RECORD FORM...P...E...R...S...O...N...L...H...E...L...T...H...N...F...O...R...M...T...IO...N... Physiotherapy... Speech Language...
https://www.southeasthealthline.ca/pdfs/400127-Rehabilitation-Therapy-Centre-Outpatient-Referral-2019-06.pdf

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