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GH - 2016 ED Info Sheet

At Halton Healthcare we strive to live our values of Compassion,...Accountability and Respect in all we do. ...Verbal or physical abuse of...patients, staff, physicians, visitors or volunteers...
https://www.mississaugahaltonhealthline.ca/pdfs/Georgetown%20Hospital%20Emergency%20Department__Fact%20Sheet.pdf

THP - 2017 Seniors Mental Health Outreach Services Brochure

• Assistance in the development of...behaviour management strategies...• Short term supportive counseling/therapy...and health teaching for clients/families...• Assessment by a nurse practitioner...
https://www.mississaugahaltonhealthline.ca/pdfs/THP%20-2017%20Seniors%20Mental%20Health%20Outreach%20Program%20Brochure.pdf

THP - 2017 Sleep Study Requisition

...b...□ Ambulatory...□ Requires a caregiver / PSW all of the time...□ Requires constant assistance to ambulate...□ Requires assistance with toileting...□ Requires a wheelchair all of the time
https://www.mississaugahaltonhealthline.ca/pdfs/THP%20-%202014%20Sleep%20Study%20Requisition.pdf

THP-Seniors Medical Psychiatry Referral Form

Lives With: □ Alone D Spouse/Partner D Family D Other: ______________________...Preferred Language: D English D Other: _________ Interpreter Required? ...D Yes D No _______...Has the client...
https://www.mississaugahaltonhealthline.ca/pdfs/THP%20-%20Centre%20for%20Seniors%20Medical%20Psychiatry%20-%202019%20Referral%20Form.pdf

TLC Baby Boutique and Breastfeeding Clinic Brochure

one pump education and assistance in a comfortable...environment....May be covered by your extended...health insurance plan...TLC...Baby Boutique...HaltonHealthcare.com/TLC...
https://www.mississaugahaltonhealthline.ca/pdfs/TLC%20-%202018%20Brochure.pdf

MDSLP-MILTON-Referral-v4-fillable.pdf

6 SPECIAL NEEDS (i.e., assistance moving, difficulty communicating)...Physician’s signature: Date:...Height Weight Gender: M F...Preferred Contact Phone...Email...PLEASE CHECK IF YOU WOULD LIKE US...
https://www.mississaugahaltonhealthline.ca/pdfs/MDSLP-MILTON-Referral-v4-fillable.pdf

OTMH - Sleep Lab Requisition

Patient requires extra assistance or support worker during study) Weight...______ Kg / lbs...Height...Physician Signature: _________________________________________...Physician Name (Print):...
https://www.mississaugahaltonhealthline.ca/pdfs/OTMH%20-%202019%20Sleep%20Lab%20Requisition.pdf

BIAPH CONSENT-TO-RELASE-OF-INFORMATION.pdf

assisting agency/person, service provider, physician, psychologist, agency staff, etc.)...Name Telephone Number (Incl. ...Area Code)...Name Telephone Number (Incl. ...Area Code)...Name Telephone...
https://www.mississaugahaltonhealthline.ca/pdfs/BIAPH%20CONSENT-TO-RELASE-OF-INFORMATION.pdf

PAH - 2018 Brochure

level of hearing loss, the use of any type of assistive device, and respect any choice...of communication. The PAH! ...program is a partnership between ROCK Reach Out...Centre For Kids and the Bob...
https://www.mississaugahaltonhealthline.ca/pdfs/PAH%20Flyer.pdf

MedSleep Queensway Sleep Lab Referral Form v9.pdf

6 SPECIAL NEEDS (i.e., assistance moving, difficulty communicating)...Physician’s signature: Date:...Height Weight Gender: M F...Preferred Contact Phone...Email...PLEASE CHECK IF YOU WOULD LIKE US...
https://www.mississaugahaltonhealthline.ca/pdfs/MedSleep%20Queensway%20Sleep%20Lab%20Referral%20Form%20v9.pdf