pdf | Cardiology: Medical transfer summary (clinic-specific template) 422 KB Download … CARDIOLOGY - Medical Transfer Summary – Transcription code #102 Patient Identification Enter Encounter # to populate: Patient Name Provincial Health Number Medical Record …

pdf | Rehabilitation Pathway After Surgery for Hip Displacement 365 KB Download … *This pathway is meant as a guideline only. All progressions of casting/splinting , weight bearing, and ROM must be confirmed by the Orthopaedic Team **Adapted from: Benard, L., …

pdf | Rehabilitation Following Single Event Multi-level Surgery 368 KB Download … *This pathway is meant as a guideline only. All progressions of casting/splinting , weight bearing, and ROM must be confirmed by the Orthopaedic Team **Adapted from: Benard, L., …

pdf | Dermatology Referral Guidelines 241 KB Download … Last updated: December 19, 2024 Pediatric Dermatology Referral Guidelines and suggestions for initial care Below recommendations do not substitute for your clinical judgement and should be taking into …

pdf | Dermatology Referral Form 138 KB Download … Dermatology Clinic REFERRAL FORM Patient information Name Address Birthdate Sex Language Interpreter? Y / N Personal Health No. Parents’ name(s) Primary phone No. Referring physician / nurse practitioner Name …

pdf | Cochlear Implant Referral Form 164 KB Download … Referring Doctor/ Audiologist Details Name: Referral Date: Telephone: Fax: Email: Address: Patient Information Child’s Name: D.O.B: Gender: P.H.N.: Government funding: Healthy Kids, Income Assistance, At …

pdf | Cochlear Implant Program Transfer Form 129 KB Download … BC Children’s Hospital – Cochlear Implant Services Room 1D 20 – 4480 Oak Street Vancouver, B. C. V6H 3V4 Phone: 604-875-2345 ext 5239 Fax 604-875-2977 AUDIOLOGY AND SPEECH LANGUAGE PATHOLOGY …

pdf | Bone Conduction Implant Program Referral Form 276 KB Download … Bone Conduction Implant Program Referral Form Hearing Implant Services Room 1D 20, 4480 Oak Street, Vancouver, BC, V6H 3V4 Fax: 604-875-2977 Phone: 604-875-2345 ext. 5239 FAX COMPLETED FORM …

pdf | ALL with CNS RT Early Follow Up Clinic 291 KB Download … ALL with CNS Radiation Therapy Pediatric Surveillance & Follow-up Guidelines Months from end of therapy Date Location H&P CBC LDH Chem Urine tests ECHO# LH, FSH, Test or Est Metab TSH, T4 Neuropsych …

pdf | ALL with CNS RT Late Effects Clinic 258 KB Download … ALL with CNS Radiation Therapy Pediatric Surveillance & Follow-up Guidelines Years from end of therapy Date Location H&P CBC & LDH Biochem Urine tests ECHO# LH, FSH, Test or Est Metab TSH, T4 Thyroid …