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Résultats

Cardiac Rehab Referral Form

https://www.princeedwardisland.ca/sites/default/files/forms/cardiac_rehab_referral_form.pdf
2022-01-19
Your physician or nurse practitioner can refer you to the , Cardiac Rehab Program,  by submitting this referral form. An exercise stress test , must,  be sent in with your referral. If you meet the inclusion criteria for the program, you will be contacted for an assessment appointment. For more...
Appendix 1: REFERRAL FORM REFERRAL FORM: CARDIAC Rehabilitation Program Date of referral: ______________ Physician/NP Signature: _______________________ Print Name:__________________ Send referrals to: Lindsay Hansen, Provincial...

Pulmonary Rehab Referral Form

https://www.princeedwardisland.ca/sites/default/files/forms/pulmonary_rehab_referral_form.pdf
2022-01-19
Your physician or nurse practitioner can refer you to the , Pulmonary Rehab Program,  by submitting this referral form. If you meet the inclusion criteria for the program, you will be contacted for an assessment appointment. For more information, visit the Cardiac and Pulmonary Rehab Programs .  
Appendix 1: REFERRAL FORM REFERRAL FORM: Pulmonary Rehabilitation Program * Please see inclusion/ exclusion criteria on reverse to ensure referral is appropriate Date of referral: ______________ Have you discussed pulmonary...

Formulaire d'objectifs des soins

https://www.princeedwardisland.ca/sites/default/files/forms/objectifs_des_soins.pdf
2016-11-23
The Goals of Care form is used by your health care provider after speaking with you and your substitute decision maker. These instructions that will guide your health care team about the general focus of your care and where you might want that care. Your health care provider will write your Goals...
Microsoft Word - Goals of Care Form.docx GOALS OF CARE Is there an existing Health Care Directive on file? No Yes (If yes, it shall guide further discussions as an indication of the Patient/Client/Resident’s wishes at time...

Diabetes Referral Form

https://www.princeedwardisland.ca/sites/default/files/forms/diabetes_referral_form.pdf
2016-10-26
Complete this form to refer or self-refer to the Provincial Diabetes Program or the Diabetes Drug Program .
Referral Provincial Diabetes Program and Diabetes Drug Program Refer to: 9 Provincial Diabetes Program Q Diabetes Drug program (Pharmacare) (check all that apply) Reason for referral: Q New diagnosis Q Re-referral Q Change of treatment Q Insulin...

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