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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
http://www.lignesantesud-est.ca/pdfs/pc_referral_form_seniors_day_rehabilitation_accident_recovery_centre.pdf

Client Onboarding Document

Hearing is believed to be the last sense to go during the dying process. ...Speak to them and about...them as if they can hear you—because they likely can. ...Use gentle tones, and if you’d like,...
http://www.lignesantesud-est.ca/pdfs/Hospice%20Guide.pdf

kingston-youth-transitions-application

What is the best way to contact you? ...(email or phone): _________________________________...Past Diagnoses, Learning Disability, Allergies or anything else:...Source of Income (OW, ODSP, CAS,...
http://www.lignesantesud-est.ca/pdfs/kingston-youth-transitions-application.pdf

September 20, 2009

I certify the foregoing information to be accurate and complete to the best of my knowledge....Signed: Date:...QELC Use: Director Approval: [ ] YES [ ] NO [ ] Request Further Information...Date:
http://www.lignesantesud-est.ca/pdfs/Queens%20Elder%20Law%20Clinic%20Client%20Application%20Form.pdf

Kingston_Access_Services_Application_Form.pdf

[ ] Kingston Access Services Website [ ] Healthcare Practitioner provided...[ ] Kingston Access Services provided via e-mail, regular mail, or office pick-up...Kingston Access Bus – Passenger...
http://www.lignesantesud-est.ca/pdfs/Kingston_Access_Services_Application_Form.pdf

2015-2016-VIQMembershipForm.pdf

Email: _______________________________ Website: ___________________________...Membership Fee Schedule...Annual budget:...[ ] up to $100,000: $50...[ ] $100,000 - $499,999: $100...[ ] over $500,000...
http://www.lignesantesud-est.ca/pdfs/2015-2016-VIQMembershipForm.pdf

VON_Stroke_Services_brochure_June 2021.pdf

emotional support to deal with life...changes related to stroke....· Meets monthly....· Focus is on practical advice; maintain a...healthy lifestyle, emotional well-being...and connections in the...
http://www.lignesantesud-est.ca/pdfs/VON_Stroke_Services_brochure_June%202021.pdf

AMHS-KFLA Fillable Referral Form 2019

*BEST way to contact patient/client:...Phone Text Email Mail...*Alternate contact person:...*Name:...*Relationship:...*Phone #:...*Can a detailed message be left? ...Y N...Substitute Decision...
http://www.lignesantesud-est.ca/pdfs/amhs-kfla_addictions_mental_health_kingston_referral_form.pdf

HPE Local Quit Smoking

visit our website for more information....Tobacco Talk Line...Learn more about the quit smoking services...offered by us and other health centres at:...HASTINGS PRINCE EDWARD PUBLIC HEALTH...600
http://www.lignesantesud-est.ca/pdfs/hpe_public_health_local_quit_smoking_support_guide.pdf

amhs-kfla_addictions_mental_health_kingston_self_referral_form.pdf

......BEST way to contact:...Alternate contact person:...COMMENTS / HOW CAN WE HELP YOU?:...SIGNATURE:...REFERRAL TAKEN BY:...Date: / /...dd mm yyyy...Mental Health...Addiction...Housing...Employment
http://www.lignesantesud-est.ca/pdfs/amhs-kfla_addictions_mental_health_kingston_self_referral_form.pdf