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Halidmand County Community Paramedic Referral Form

o Increased risk of falls (1 fall in 3 months) o Social Isolation or Living Alone...o Multiple Co-morbidities (>3) o Cognitive Impairment...o No Primary Care Provider o Geographical Isolation...o...
https://www.hnhbhealthline.ca/pdfs/Haldimand%20County%20Community%20Paramedic%20Referral%20Form.pdf

Cyan Modern Medical Service Trifold Brochure

...ivers,...supervisors, or contact our office with...any concerns, clarifications, or changes...to your care plan. ...We are happy to...discuss and assist with your needs....BOOK YOUR...APPOINTMENT!
https://www.hnhbhealthline.ca/pdfs/Carebridge%20Home%20Healthcare%20-%20Brochure.pdf

Chapel Heights Respite Recovery Health Care Patient Card

☛ 2 Person Assists & Lifts...☛ Medication Administration...☛ Rise & Shine (AM) & Retire (PM)...Support...☛ Bathing Assistance...☛ In House Physio Assessement...☛ In House Rehab Therapy...☛...
https://www.hnhbhealthline.ca/pdfs/Chapel%20Heights%20Respite%20Recovery%20Health%20Care%20Patient%20Card.pdf

Neenah Navasero Neurorehabilitation Brochure

ing in their lives in meaningful ways....In her free time she enjoys playing and coaching ulti-...mate Frisbee and baking sourdough bread!...AREAS OF PRACTICE...Brain injury, stroke, spinal cord...
https://www.hnhbhealthline.ca/pdfs/Neenah%20Navasero%20Neurorehabilitation%20Brochure.pdf

BSO Connect Flyer

and other agencies to access assistance for older adults with age related cognitive impairments and...responsive behaviours* that impact their daily functioning and/or the ability to maintain...
https://www.hnhbhealthline.ca/pdfs/BSO_Connect_Flyer.pdf

Dundas Community Services Meals on Wheels Registration Form

Do you live alone? Y____/N____ With Whom? ...__________________________________________________...Meal Details: MON ____ TUES ____ WED ____ THURS ____ FRI ____...Extra meals for the weekend? ...Or...
https://www.hnhbhealthline.ca/pdfs/Dundas%20Community%20Services%20Meals%20on%20Wheels%20Registration%20Form.pdf

CannabisClinic_ReferralForm_2020-05_EN_Fillable.pdf

...t....1-888-256-7043 | cannabisclinics.ca...Support and Guidance...Canadian Cannabis Clinics provides education, assistance with licensed...producer registration, and ongoing care to every patient.
https://www.hnhbhealthline.ca/pdfs/CannabisClinic_ReferralForm_2020-05_EN_Fillable.pdf

Community Internal Medicine Rapid Access Clinic Referral Form

Translator Yes No Mobility Assistance Yes No...Does patient have cognitive impairment Yes No...Does patient have a psychiatric diagnosis Yes No...Referral Physician Printed Name:...
https://www.hnhbhealthline.ca/pdfs/C-IMRAC%20Referral%20Form.pdf

Youth Early Intervention Referral Form

live in Burlington, Ontario...5. ...referred by a professional at one of our community child and adolescent partners....The eligibility criteria for the assessment and treatment (EI) stream are as...
https://www.hnhbhealthline.ca/pdfs/Youth%20Early%20Intervention%20Referral%20Form.pdf

SURE Program Brochure

Changing lives tomorrow....How does this program work?...Within a family group setting this program provides...knowledge and skills in self-understanding and regulating...emotions for youth...
https://www.hnhbhealthline.ca/pdfs/SURE%20Program%20Brochure.pdf