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Hospital for Sick Children (The) - Adolescent Medicine - Adolescent Medicine - Eating Disorders Day Treatment Program
Treatment can include psychiatric care, ongoing medical care to
prevent
complications caused by the eating disorder, group therapy, family therapy, individual therapy and advice about healthy...
https://www.southeasthealthline.ca/displayService.aspx?id=145423
Ontario. Ministry of Health - Ontario Public Drug Programs - Ontario Naloxone Program for Pharmacies
Provincial program to provide naloxone kits through pharmacies, community organizations and provincial correctional facilities * prescription not required, but training is provided * naloxone can help...
https://www.southeasthealthline.ca/displayService.aspx?id=173755
Voir en français
400971-RMandR-Rehabilitation-Referral-Form-2017-03.pdf
At the time of discharge from acute care, acute medical issues have been addressed:
disease
processes...and/or impairments are not precluding participation in rehabilitation program.......
https://www.southeasthealthline.ca/pdfs/400971-RMandR-Rehabilitation-Referral-Form-2017-03.pdf
Referral_Form_Wound_Foot_Care.pdf
who have high risk
chronic
illness and advanced foot problems that do not have any health...insurance coverage, or for those who have exhausted their insurance coverage for wound and...foot care...
https://www.southeasthealthline.ca/pdfs/Referral_Form_Wound_Foot_Care.pdf
rac_lbp_patient_intake_form_march_2020.pdf
Heart Attack/Coronary Artery
Disease
No Yes Ulcer or Stomach
Disease
No Yes... Heart Failure No Yes Thyroid
Disease
No Yes... Lung
Disease
(e.g. ...asthma,...
https://www.southeasthealthline.ca/pdfs/rac_lbp_patient_intake_form_march_2020.pdf
CPC Patient Information Sheet
or
chronic
condition that led to a decline...in function or movement....You must also:...1. ...Have a valid Ontario health card, and...2. ...Be 65 years or older, 19 years or...younger, or any age...
https://www.southeasthealthline.ca/pdfs/Napanee%20Physiotherapy%20and%20Rehabilitation%20-%20OHIP%20Insured%20Physiotherapy%20Information.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
Alz Society Kingston Referral Form.pdf
...s:...Alzheimer’s
Disease
Vascular Dementia Frontotemporal Dementia...Lewy-Body Dementia Mixed Dementia MCI...Korsakoff’s Syndrome Dementia due to head trauma...Dementia due to other illness (i.e.
https://www.southeasthealthline.ca/pdfs/Alz%20Society%20Kingston%20Referral%20Form.pdf
PULMONARY REHABILITATION PROGRAM
• No cardiac
disease
which
prevents
partaking in exercise (most undergo Stage II exercise...test at HDH)...• No significant musculoskeletal issues that preclude meaningful participation...
https://www.southeasthealthline.ca/pdfs/SMOL-Referral-Form-1.pdf
AMHS-KFLA Fillable Referral Form 2019
CHRONIC
ILLNESS...PSYCHIATRIC DIAGNOSIS(ES)...ANXIETY PERSONALITY DISORDER...BI-POLAR DISORDER...DEPRESSION SCHIZOPHRENIA...tDUAL DIAGNOSIS (Intellectual Disability & Mental Illness)...COMMENTS:
https://www.southeasthealthline.ca/pdfs/amhs-kfla_addictions_mental_health_kingston_referral_form.pdf
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