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Town of Tillsonburg Fitness Program Application 2019

Please return completed forms to Mark Salt at Tillsonburg Community Centre...Or Email a scanned copy to: msalt@tillsonburg.ca...Fitness Program Application...Personal Details...Name:...
https://www.southwesthealthline.ca/pdfs/Tillsonburg_Town_of_Accessible_Fitness_Application_2019.pdf

Senior Centre Brochure

support physical, mental, and social...wellbeing....Whether you want to meet new people,...learn a new skill, or just get out and enjoy...time with your peers, the Senior Centre is...the place to...
https://www.southwesthealthline.ca/pdfs/Senior%20Centre%20Brochure.pdf

Brightshores Health System - Owen Sound Hospital - Grey Bruce District Stroke Centre - Stroke Prevention Clinic Referral Form - Jan 2026

*INCLUDE SUPPORTING DOCUMENTATION*...M-230 Revised Jan 2026...Signs/Symptoms eg. ...Unilateral weakness, numbness, speech disturbances...vertigo, vision changes...R L...7 day...Side...Yes No...☐...
https://www.southwesthealthline.ca/pdfs/Brightshores%20Health%20System%20-%20Owen%20Sound%20Hospital%20-%20Grey%20Bruce%20District%20Stroke%20Centre%20-%20Stroke%20Prevention%20Clinic%20Referral%20Form.pdf

Rapid_Access_ Clinic_Brochure

We will also connect you with resources in your community....• Patients may be given the option for a follow-up appointment at...the Rapid Access Clinic which will track your referral....Hours of...
https://www.southwesthealthline.ca/pdfs/Rapid_Access_Clinic_Brochure.pdf

Aragon Prosthodontics Referral Form

• Is patient interested in implant supported dentures? ...Y N...€ Dental implant restorations...€ Implant retained complete fixed dentures/partial dentures...€ Full mouth rehabilitation...€...
https://www.southwesthealthline.ca/pdfs/aragon_prosthodontics_referral_form_2018.pdf

Parkwood Institute Main Building - Inpatient Referral Form

• Care needs cannot otherwise be met in the community:...CLINICAL PROFILE...Primary Medical Diagnosis:...Date and Description of Event (example: stroke, trauma, fall):...Etiology:...Surgical...
https://www.southwesthealthline.ca/pdfs/parkwoodaccess_referralform.pdf

St. Joseph's Health Care London Geriatric Referral Form 2006

Specialized Geriatric Services Intake/Referral Form...Tel: (519) 685-4046 Fax: (519) 685-4020...Mailing Address: 801 Commissioners Road East, London ON N6C 5J1...What service does this...
https://www.southwesthealthline.ca/pdfs/SJ_Geriatric_Referral_Form.pdf

LHSC Sleep & Apnea Assesment Unit Information Brochure 2014

service....What time will I be discharged?...Discharge is at 6:30 a.m....Contacting Us...Sleep & Apnea Assessment Unit...Monday to Friday (8:00 a.m. ...to 4:00 p.m.)...Booking Secretary...Email:...
https://www.southwesthealthline.ca/pdfs/SleepApneaAssesmentUnit_InformationBrochure.pdf

WECHC_ReferralApplicationForm_2019.docx

Referral Form for Counselling Services at WECHC Please note: There is currently a waitlist for counseling services. All referrals will be handled in a confidential manner and will become...
https://www.southwesthealthline.ca/pdfs/WECHC_ReferralApplicationForm_2019.docx

Treating Patients with CARE 2013

While some general concepts about customer service from retail and service industries may apply to health care, in many ways health...care is different. It’s not the same as selling...
https://www.southwesthealthline.ca/pdfs/TreatingPatientswithCARE.pdf