
Custom Forms
Find Forms Fast
Browse all custom forms and eForms in the HFHT Library below
Need help with Accuro or P&P forms? Contact your Quality Improvement Specialist.
Can’t find what you need? Email: help.centre@hamiltonfht.ca.
Custom Forms (New/Updated)
Form | Form Categories | Subject | EMR | 1st Page Preview | Form Location | Link | Date Modified | hf:doc_categories | hf:doc_tags |
---|---|---|---|---|---|---|---|---|---|
2019 Lab Requisition | Lab Requisitions | MOH | Telus PS | Download | 16 December 2024 | lab-requisitions custom-form | moh | ||
Absolute Medical Centre – Chronic Pain Injections | Referrals | Pain | Telus PS | Download | 28 November 2024 | referrals custom-form | pain | ||
Absolute Medical Centre – EMG Request | Referrals | EMG | Telus PS | Download | 28 November 2024 | referrals custom-form | emg | ||
Abundance Healthcare | Pain | Fibromyalgia, Pain | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | fibromyalgia pain | ||
Alfa-Scan – Xray and Ultrasound | Imaging | Ultrasound, X-Ray | Telus PS | Download | 28 November 2024 | imaging custom-form | ultrasound x-ray | ||
Ancaster Cardiology | Referrals | Cardiology | Telus PS | Download | 28 November 2024 | referrals custom-form | cardiology | ||
Ancaster X-ray and Ultrasound | Imaging | Ultrasound, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound x-ray | ||
AVIVA – Allergy Asthma Immunology | Referrals | Allergy, Asthma, Immunology | Telus PS | Download | 28 November 2024 | referrals custom-form | allergy asthma immunology | ||
BIICE – Burlington IUC & Implant Centre of Excellence | Referrals | IUC | Telus PS | Download | 28 November 2024 | referrals custom-form | iuc | ||
BLC Medical Specialists – Burlington | Referrals | Respirology | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | respirology | ||
BLC Medical Specialists – Stoney Creek | Referrals | Respirology | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | respirology | ||
BounceBack Ontario | Mental Health | Mental Health | Ocean eReferral | Ocean Link | 28 November 2024 | mental-health custom-form | mental-health | ||
Brantford General Hospital – Medical Imaging | Imaging | BGH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | bgh | ||
Brantford Radiology Group – Brant Imaging Clinic | Imaging | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | brg radiology | ||
Brantford Radiology Group – King George Clinic | Imaging | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | brg radiology | ||
Brantford Radiology Group – Paris Medical Imaging | Imaging | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | brg radiology | ||
Brantford Radiology Group – Shellington Imaging Clinic | Imaging | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | brg radiology | ||
Brantford Radiology Group – St. Paul Imaging Clinic | Imaging | BRG, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | brg radiology | ||
Cardio Study of Hamilton | Imaging | Cardiology | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology | ||
Centre for Sleep Disorders | Referrals | Sleep Medicine | Telus PS | Download | 28 November 2024 | referrals custom-form | sleep-medicine | ||
Charlton X-ray | Imaging | X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | x-ray | ||
Chronic-Cough Canada | Referrals | Cough | Telus PS | Download | 28 November 2024 | referrals custom-form | cough | ||
Compass CHC Caring for My COPD Pulmonary Rehab Program | Imaging | Compass CHC, Pulmonary | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | compass-chc pulmonary | ||
Compass CHC Diabetes Education Program | Diabetes | Compass CHC | Ocean eReferral | Ocean Link | 28 November 2024 | diabetes custom-form | compass-chc | ||
Compass CHC Diabetes Foot Health Program – Brantford | Diabetes | Compass CHC, Diabetes, featureimage | Ocean eReferral | Ocean Link | 28 November 2024 | diabetes custom-form | compass-chc diabetes featureimage | ||
Compass CHC Diabetes Foot Health Program – Burlington | Diabetes | Compass CHC, Diabetes, featureimage | Ocean eReferral | Ocean Link | 28 November 2024 | diabetes custom-form | compass-chc diabetes featureimage | ||
Compass CHC Diabetes Foot Health Program – Hamilton Mountain | Diabetes | Compass CHC, Diabetes, featureimage | Ocean eReferral | Ocean Link | 28 November 2024 | diabetes custom-form | compass-chc diabetes featureimage | ||
Compass CHC Diabetes Foot Health Program – Niagara Falls | Diabetes | Compass CHC, Diabetes, featureimage | Ocean eReferral | Ocean Link | 28 November 2024 | diabetes custom-form | compass-chc diabetes featureimage | ||
Compass CHC Diabetes Foot Health Program – North Hamilton | Diabetes | Compass CHC, Diabetes, featureimage | Ocean eReferral | Ocean Link | 28 November 2024 | diabetes custom-form | compass-chc diabetes featureimage | ||
Compass CHC Diabetes Foot Health Program – St. Catharines | Diabetes | Compass CHC, Diabetes, featureimage | Ocean eReferral | Ocean Link | 28 November 2024 | diabetes custom-form | compass-chc diabetes featureimage | ||
Compass CHC Diabetes Foot Health Program – Stoney Creek | Diabetes | Compass CHC, Diabetes, featureimage | Ocean eReferral | Ocean Link | 28 November 2024 | diabetes custom-form | compass-chc diabetes featureimage | ||
Compass CHC Diabetes Foot Health Program – Welland | Diabetes | Compass CHC, Diabetes, featureimage | Ocean eReferral | Ocean Link | 28 November 2024 | diabetes custom-form | compass-chc diabetes featureimage | ||
CRA Disability Tax Credit Certificate 2023 | Miscellaneous | Disability | Telus PS | Download | 16 December 2024 | miscellaneous custom-form | disability | ||
Crown Point Midwifery | Referrals | Midwifery, Prenatal | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | midwifery prenatal | ||
Cytology & HPV Testing Requisition – LifeLabs | Lab Requisitions | cytology, featureimage, HPV, Lifelabs | Telus PS | Download | 28 November 2024 | lab-requisitions custom-form | cytology featureimage hpv lifelabs | ||
Direct Care Bayshore – Patient Enrolment & Medical Order Form | Referrals | Telus PS | Download | 28 November 2024 | referrals custom-form | ||||
Dundas Medical Imaging | Imaging | Cardiology, Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology ultrasound | ||
Dynacare Harmony Prenatal Test | Lab Requisitions | Dynacare, Prenatal | Telus PS | Download | 16 December 2024 | lab-requisitions custom-form | dynacare prenatal | ||
ELM Medicine | Referrals | Internal Medicine, Pain | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | internal-medicine pain | ||
GHA Surgical Centre | Endoscopy | Referrals | Endoscopy | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | endoscopy | ||
GNMI – Hamilton (Nebo Rd) | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
GNMI – Hamilton (Queenston Rd) | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
GNMI – Niagara Falls (McLeod Rd) | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
GNMI – Niagara Falls (Portage Rd) | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
GNMI – St. Catharines (Linwell Rd) | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
GNMI – St. Catharines (Pelham Rd) | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
GNMI – St. Catharines (Welland Ave) | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
GNMI – Stratford | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
GNMI – Welland (Prince Charles Dr) | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
GNMI MRI & CT – Ajax | Imaging | GNMI | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gnmi | ||
Halton-Niagara-Southern Ontario Sports and Exercise Medicine | Referrals | Sports Medicine | Telus PS | Download | 28 November 2024 | referrals custom-form | sports-medicine | ||
Hamilton Birth Control Clinic | Referrals | Telus PS | Download | 28 November 2024 | referrals custom-form | ||||
Hamilton General Hospital – Cardio Metabolic Centre of Excellence | Referrals | HGH | Telus PS | Download | 28 November 2024 | referrals custom-form | hgh | ||
Hamilton Health Sciences – Acquired Brain Injury Program | Referrals | Brain, HHS | Telus PS | Download | 28 November 2024 | referrals custom-form | brain hhs | ||
Hamilton Health Sciences – Adult Concussion Clinic | Referrals | Concussion, HHS | Telus PS | Download | 28 November 2024 | referrals custom-form | concussion hhs | ||
Hamilton Health Sciences – Breast MR Consult | Imaging | HHS | Telus PS | Download | 28 November 2024 | imaging custom-form | hhs | ||
Hamilton Health Sciences – Cancer Genetics Consultation | Referrals | Cancer Care, HHS | Telus PS | Download | 28 November 2024 | referrals custom-form | cancer-care hhs | ||
Hamilton Health Sciences – Cardiac/Coronary CT | Referrals | Cardiology, HHS | Telus PS | Download | 28 November 2024 | referrals custom-form | cardiology hhs | ||
Hamilton Health Sciences – McMaster – Valve Clinic | Referrals | HHS, McMaster | Telus PS | Download | 28 November 2024 | referrals custom-form | hhs mcmaster | ||
Hamilton Health Sciences – Medical Certificate of Disability | Miscellaneous | Disability, HHS | Telus PS | Download | 28 November 2024 | miscellaneous custom-form | disability hhs | ||
Hamilton Health Sciences – Medical Diagnostic Unit Requisition (MDU) | Imaging | HHS, MDU | Telus PS | Download | 28 November 2024 | imaging custom-form | hhs mdu | ||
Hamilton Health Sciences – Michael DeGroote Pain Management Program | Referrals | HHS, Pain | Telus PS | Download | 28 November 2024 | referrals custom-form | hhs pain | ||
Hamilton Health Sciences – MRI Consultation | Imaging | HHS, MRI | Telus PS | Download | 28 November 2024 | imaging custom-form | hhs mri | ||
Hamilton Health Sciences – MUMC – Adult Outpatient Swallowing Form | Referrals | HHS, MUMC | Telus PS | Download | 16 December 2024 | referrals custom-form | hhs mumc | ||
Hamilton Health Sciences – Nuclear Medicine Requisition | Imaging | HHS, Nuclear Medicine | Telus PS | Download | 28 November 2024 | imaging custom-form | hhs nuclear-medicine | ||
Hamilton Health Sciences – Nuclear Medicine Requisition – With Instructions | Imaging | HHS, Nuclear Medicine | Telus PS | Download | 28 November 2024 | imaging custom-form | hhs nuclear-medicine | ||
Hamilton Health Sciences – Request for CT Consultation | Imaging | CT, HHS | Telus PS | Download | 28 November 2024 | imaging custom-form | ct hhs | ||
Hamilton Health Sciences – Request for CT Consultation – With Instructions | Imaging | CT, HHS | Telus PS | Download | 28 November 2024 | imaging custom-form | ct hhs | ||
Hamilton Health Sciences – Voice Clinic | Referrals | HHS | Telus PS | Download | 28 November 2024 | referrals custom-form | hhs | ||
Hamilton Orthopaedic Institute – MSK Injury Clinic | Referrals | MSK, Orthopaedic | Telus PS | Download | 28 November 2024 | referrals custom-form | msk orthopaedic | ||
Hamilton Pain Clinic – Chronic Pain | Pain | Pain | Telus PS | Download | 28 November 2024 | pain custom-form | pain | ||
Hamilton Palliative Care Outreach Team Referral | Referrals | Palliative Care | Telus PS | Download | 28 November 2024 | referrals custom-form | palliative-care | ||
Hamilton Primary Care Skin Disorders Clinic | Referrals | Skin Disorders | Telus PS | Download | 28 November 2024 | referrals custom-form | skin-disorders | ||
Hamilton Vascular Laboratory | Imaging | Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound | ||
Heart and Health Clinic Requisition | Referrals | Cardiology | Telus PS | Download | 28 November 2024 | referrals custom-form | cardiology | ||
High Risk Ontario Breast Screening Program (OBSP) – Breast Cancer Genetic Assessment Results Form | Imaging | high risk screening, obsp | Telus PS | Download | 28 November 2024 | imaging custom-form | high-risk-screening obsp | ||
High Risk Ontario Breast Screening Program (OBSP) Requisition | Imaging | high risk screening, obsp | Telus PS | Download | 28 November 2024 | imaging custom-form | high-risk-screening obsp | ||
HNHB – Request for Ontario Health atHome Services | Referrals | HNHB, Ontario Health | Telus PS | Download | 28 November 2024 | referrals custom-form | hnhb ontario-health | ||
HNHB – Request for Ontario Health atHome Services – With Instructions | Referrals | HNHB, Ontario Health | Telus PS | Download | 28 November 2024 | referrals custom-form | hnhb ontario-health | ||
HNHB Behavioural Supports Ontario – Geriatric Services – Central Clinical Intake Referral – With Instructions | Referrals | BSO, CCI, Geriatric | Telus PS | Download | 28 November 2024 | referrals custom-form | bso cci geriatric | ||
HNHB Behavioural Supports Ontario – Geriatric Services – Central Clinical Intake Referral | Referrals | BSO, CCI, Geriatric | Telus PS | Download | 28 November 2024 | referrals custom-form | bso cci geriatric | ||
HNHB Regional Aphasia Programs | Referrals | HNHB | Telus PS | Download | 28 November 2024 | referrals custom-form | hnhb | ||
HNHB Regional Cancer Program – Colonoscopy Referral | Referrals | Cancer Care, HNHB | Telus PS | Download | 28 November 2024 | referrals custom-form | cancer-care hnhb | ||
HNHBLHIN – MRI Req | Imaging | HNHB, MRI | Telus PS | Download | 28 November 2024 | imaging custom-form | hnhb mri | ||
HNHBLHIN – Palliative Symptom Response Order Form | Miscellaneous | HNHB, Palliative Care | Telus PS | Download | 28 November 2024 | miscellaneous custom-form | hnhb palliative-care | ||
JHCC-CIBC-BAC-Breast Referral Form | Referrals | HHS | Telus PS | Download | 28 November 2024 | referrals custom-form | hhs | ||
Joseph Brant Hospital – Ambulatory Care | Referrals | JBH | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | jbh | ||
Joseph Brant Hospital Child and Adolescent Psychiatry Clinic | Mental Health | JBH, Psychiatry | Ocean eReferral | Ocean Link | 28 November 2024 | mental-health custom-form | jbh psychiatry | ||
Joseph Brant Hospital Diagnostic Imaging | Imaging | JBH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | jbh | ||
Joseph Brant Hospital Medical Diagnostic Unit | Imaging | JBH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | jbh | ||
Kitchener-Waterloo Vascular Laboratory | Imaging | Cardiology, Vascular | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology vascular | ||
KMH Cardiology & MRI Centre – Markham | Imaging | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology kmh | ||
KMH Cardiology & PET/CT Centre – Mississauga | Imaging | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology kmh | ||
KMH Cardiology Centre – Burlington | Imaging | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology kmh | ||
KMH Cardiology Centre – Hamilton | Imaging | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology kmh | ||
KMH Cardiology Centre – North York | Imaging | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology kmh | ||
KMH Cardiology Centre – Scarborough | Imaging | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology kmh | ||
KMH Cardiology Centre – St. Catharines | Imaging | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology kmh | ||
KMH Cardiology Centre – Toronto | Imaging | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology kmh | ||
KMH Cardiology Centre – Woodstock | Imaging | Cardiology, KMH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology kmh | ||
Locke Medical Clinic – Consultation-EMG-NCS | Referrals | EMG, NCS | Telus PS | Download | 28 November 2024 | referrals custom-form | emg ncs | ||
m-Health Solutions Holter Monitoring | Imaging | ECG | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ecg | ||
Main Ultrasound | Imaging | Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound | ||
McMaster Children’s Hospital – Pediatric Adolescent Medicine Program | Referrals | McMaster, Pediatric | Telus PS | Download | 28 November 2024 | referrals custom-form | mcmaster pediatric | ||
McMaster Children’s Hospital – Pediatric Respirology & Allergy | Referrals | Allergy, McMaster, Pediatric | Telus PS | Download | 28 November 2024 | referrals custom-form | allergy mcmaster pediatric | ||
McMaster Children’s Hospital – Pediatric Sleep Medicine | Referrals | McMaster, Pediatric, Sleep Medicine | Telus PS | Download | 28 November 2024 | referrals custom-form | mcmaster pediatric sleep-medicine | ||
McMaster Children’s Hospital – Psychiatry Consultation | Referrals | McMaster, Psychiatry | Telus PS | Download | 28 November 2024 | referrals custom-form | mcmaster psychiatry | ||
McMaster Spine Surgery – New Consult Requisition Form | Miscellaneous | McMaster | Telus PS | Download | 28 November 2024 | miscellaneous custom-form | mcmaster | ||
Medical Certificate for Employment Insurance Care Benefits | Miscellaneous | Telus PS | Download | 28 November 2024 | miscellaneous custom-form | ||||
Medisen Cardiology and Internal Medicine | Imaging | Cardiology, Internal Medicine | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology internal-medicine | ||
MedSleep Niagara Falls | Referrals | Sleep Medicine | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | sleep-medicine | ||
Minerva Comprehensive Pain Management | Pain | Pain | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain | ||
Misistry of Health – Patient Enrolment and Consent to Release Personal Health Information | Ministry of Health | Consent, MOH, PHI | Telus PS | Download | 28 November 2024 | ministry-of-health custom-form | consent moh phi | ||
Mount Sinai Hospital – Joint Department of Medical Imaging (JDMI) | Imaging | Bone, CT, Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | bone ct ultrasound | ||
MUMC – 3F Pediatric Ambulatory Clinics | Referrals | Pediatric | Telus PS | Download | 28 November 2024 | referrals custom-form | pediatric | ||
NEJAC – Rapid Access Clinic | Referrals | Telus PS | Download | 28 November 2024 | referrals custom-form | ||||
Niagara Health Diagnostic Imaging | Imaging | Ultrasound, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound x-ray | ||
North Bay cardiology | Referrals | Cardiology | Telus PS | Download | 28 November 2024 | referrals custom-form | cardiology | ||
Oakville North Endoscopy | Referrals | Endoscopy | Telus PS | Download | 28 November 2024 | referrals custom-form | endoscopy | ||
One Vascular Requisition | Imaging | Vascular | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | vascular | ||
Ontario Breastfeeding Clinic (OBC) – Physician Group Referral | Referrals | Telus PS | Download | 28 November 2024 | referrals custom-form | ||||
Ontario Health – Lung Screening Program | Referrals | Lung, Ontario Health | Telus PS | Download | 28 November 2024 | referrals custom-form | lung ontario-health | ||
Ontario Health – Lung Screening Program – With Instructions | Referrals | Lung, Ontario Health | Telus PS | Download | 28 November 2024 | referrals custom-form | lung ontario-health | ||
Ontario Health – Lung Screening Program – SJH | Referrals | Lung, Ontario Health | Telus PS | Download | 16 December 2024 | referrals custom-form | lung ontario-health | ||
Ontario Health – Lung Screening Program – SJH – With Instructions | Referrals | Lung, Ontario Health | Telus PS | Download | 16 December 2024 | referrals custom-form | lung ontario-health | ||
Ontario Health atHome – HNHB First Dose IV Risk Assesment | Referrals | Ontario Health | Telus PS | Download | 28 November 2024 | referrals custom-form | ontario-health | ||
Ontario Health atHome – HNHB Iron Infusion Order Form | Referrals | Ontario Health | Telus PS | Download | 28 November 2024 | referrals custom-form | ontario-health | ||
Ontario Health atHome – HNHB Iron Infusion Order Form – With Instructions | Referrals | Ontario Health | Telus PS | Download | 28 November 2024 | referrals custom-form | ontario-health | ||
Ontario Health atHome Waterloo Wellington | Referrals | Ontario Health | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | ontario-health | ||
Ontario Structured Psychotherapy West | Mental Health | OSPW | Ocean eReferral | Ocean Link | 28 November 2024 | mental-health custom-form | ospw | ||
Organon Aspire – NEXPLANON – Scheduling Support Appointment Form | Miscellaneous | NEXPLANON | Telus PS | Download | 16 December 2024 | miscellaneous custom-form | nexplanon | ||
Pain Care Clinic – Hamilton | Pain | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain pcc | ||
Pain Care Clinic – Kitchener | Pain | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain pcc | ||
Pain Care Clinic – Mississauga | Pain | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain pcc | ||
Pain Care Clinic – Niagara Falls | Pain | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain pcc | ||
Pain Care Clinic – Orangeville | Pain | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain pcc | ||
Pain Care Clinic – St. Catherines | Pain | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain pcc | ||
Pain Care Clinic – Welland | Pain | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain pcc | ||
Pain Care Clinic – Windsor | Pain | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain pcc | ||
Pain Care Clinic – Windsor County | Pain | Pain, PCC | Ocean eReferral | Ocean Link | 28 November 2024 | pain custom-form | pain pcc | ||
Possibilities Clinic | Referrals | ADHD, Mental Health | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | adhd mental-health | ||
Precision Care Centre | Imaging | Pain, Radiology | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | pain radiology | ||
Provis Endoscopy Services – Ottawa East | Referrals | Endoscopy | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | endoscopy | ||
Public Health Ontario – General Test Requisition | Lab Requisitions | featureimage, PHO, public health | Telus PS | Download | 28 November 2024 | lab-requisitions custom-form | featureimage pho public-health | ||
Public Health Ontario – General Test Requisition – With Instructions | Lab Requisitions | featureimage, PHO, public health | Telus PS | Download | 28 November 2024 | lab-requisitions custom-form | featureimage pho public-health | ||
Public Health Ontario – Reference Bacteriology Requisition | Lab Requisitions | bacteriology, featureimage, PHO, public health | Telus PS | Download | 28 November 2024 | lab-requisitions custom-form | bacteriology featureimage pho public-health | ||
Public Health Ontario – Report of Adverse Event Following Immunization – 2024 | Miscellaneous | PHO, public health | Telus PS | Download | 28 November 2024 | miscellaneous custom-form | pho public-health | ||
Public Health Services Hamilton – Chlamydia Surveillance Package CICW | Lab Requisitions | Chlamydia, featureimage, PHO, public health | Telus PS | Download | 28 November 2024 | lab-requisitions custom-form | chlamydia featureimage pho public-health | ||
Public Health Services Hamilton – Gonorrhea Surveillance Package CICW | Lab Requisitions | featureimage, Gonorrhea, PHO, public health | Telus PS | Download | 28 November 2024 | lab-requisitions custom-form | featureimage gonorrhea pho public-health | ||
Public Health Services Hamilton – Positive TB Skin Test (TST) | Lab Requisitions | featureimage, Skin, TB | Telus PS | Download | 28 November 2024 | lab-requisitions custom-form | featureimage skin tb | ||
Request for Boehringer Ingelheim – Medication Form | Miscellaneous | Medication | Telus PS | Download | 28 November 2024 | miscellaneous custom-form | medication | ||
Restore Hyperbaric Oxygen and Medical Centre | Referrals | Oxygen | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | oxygen | ||
Southwest Ultrasound | Imaging | Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound | ||
St. Joseph’s Healthcare Hamilton – Connect Mental Health and Addiction Outpatient Programs | Mental Health | addiction, Mental Health, SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | mental-health custom-form | addiction mental-health sjhh | ||
St. Joseph’s Healthcare Hamilton – Diagnostic Imaging – Charlton Campus | Imaging | SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | sjhh | ||
St. Joseph’s Healthcare Hamilton – Diagnostic Imaging – King Campus | Imaging | SJHH | Ocean eReferral | Ocean Link | 16 December 2024 | imaging custom-form | sjhh | ||
St. Joseph’s Healthcare Hamilton – Diagnostic Imaging – West 5th Campus | Imaging | SJHH | Ocean eReferral | Ocean Link | 16 December 2024 | imaging custom-form | sjhh | ||
St. Joseph’s Healthcare Hamilton – Esophageal Diagnostic Assessment Program | Referrals | SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | sjhh | ||
St. Joseph’s Healthcare Hamilton – IV Iron Replacement Order Set | Miscellaneous | IV Iron, SJH | Telus PS | Download | 28 November 2024 | miscellaneous custom-form | iv-iron sjh | ||
St. Joseph’s Healthcare Hamilton – Obstetrics & Gynecology 2 Fontbonne | Referrals | Gynecology, Obstetrics, SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | gynecology obstetrics sjhh | ||
St. Joseph’s Healthcare Hamilton – Outpatient Nephrology | Referrals | Nephrology, SJHH | Ocean eReferral | Ocean Link | 28 November 2024 | referrals custom-form | nephrology sjhh | ||
St. Joseph’s Healthcare London – ROTH McFarlane Hand and Upper Limb Centre | Referrals | SJH | Telus PS | Download | 28 November 2024 | referrals custom-form | sjh | ||
SUGO – Specialized Ultrasound in Gynecology & Obstetrics | Imaging | Gynecology, Obstetrics, Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | gynecology obstetrics ultrasound | ||
The Minor Surgery Center | Referrals | TMSC | Telus PS | Download | 28 November 2024 | referrals custom-form | tmsc | ||
UHN – Centre for Mental Health | Referrals | Mental Health | Telus PS | Download | 28 November 2024 | referrals custom-form | mental-health | ||
UltraScan Medical Diagnostic Imaging | Imaging | Ultrasound | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound | ||
WELL Health Diagnostic Centres – Brantford – Cardiology | Imaging | Cardiology | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology | ||
WELL Health Diagnostic Centres – Mississauga – Cardiology | Imaging | Cardiology | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | cardiology | ||
Wentworth-Halton X-Ray and Ultrasound Inc. – 15 Mountain Ave | Imaging | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound wh x-ray | ||
Wentworth-Halton X-Ray and Ultrasound Inc. – 325 Winterberry Drive | Imaging | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound wh x-ray | ||
Wentworth-Halton X-Ray and Ultrasound Inc. – Medical Arts | Imaging | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound wh x-ray | ||
Wentworth-Halton X-Ray and Ultrasound Inc. – Waterdown | Imaging | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound wh x-ray | ||
Wentworth-Halton X-Ray and Ultrasound Inc. – Westmount | Imaging | Ultrasound, WH, X-Ray | Ocean eReferral | Ocean Link | 28 November 2024 | imaging custom-form | ultrasound wh x-ray | ||
Women’s College Hospital – Mental Health | Referrals | Mental Health, WCH | Telus PS | Download | 28 November 2024 | referrals custom-form | mental-health wch |
Custom Form Archive (Older Forms)
Form | Form Categories | Subject | EMR | 1st Page Preview | Form Location | Link | Date Modified |
---|