Forms

TitleDescriptionVersionSizeDownload
Aspirin Exacerbated Disease (AERD) Clinic Referral 182.96 KB DownloadPreview
Blank Prescribers Orders PHC-PH099(R. Oct 2015) BC57.96 KB DownloadPreview
Blank Prescribers Orders R. Feb 7, 2023206.96 KB DownloadPreview
Cardiology Lab Requisition (Hard Copy) EK002(R.Jul-03)BC22.05 KB DownloadPreview
Caution Form Allergy Intolerance Status PHC-PH047(R June 27 -17)BC22.66 KB DownloadPreview
Consent for Transfusion of Blood and or Blood Products PHC-MR030(R Jan 10-13)BC(2)21.65 KB DownloadPreview
Consent to Treatment PHC-MR002(R. Dec-07)BC(1)28.74 KB DownloadPreview
DT Procedure Room Pre-op History Patient Questionnaire 3007 (PHC-OP116)(R. May 11-21)fillable438.98 KB DownloadPreview
Diabetic Health Centre Referral DB145(R. Feb 4-21)165.75 KB DownloadPreview
ED Instructions for SDPts 2016 (Chinese Simplified) T53068502.74 KB DownloadPreview
ED Instructions for SDPts 2016 (Chinese Traditional) T53068473.05 KB DownloadPreview
ED Instructions for SDPts 2016 (Persian) T53068404.60 KB DownloadPreview
ED Instructions for SDPts 2016 (Punjabi) T53068396.65 KB DownloadPreview
EMG-Nerve Conduction Studies Requisition PHC-EE011(R. Jun-11)BC404.88 KB DownloadPreview
General Internal Medicine Clinic Referral 280.85 KB DownloadPreview
Gynecology Thromboprophylaxis Risk Assessment Tool OB115(Jan 19-12)BC34.02 KB DownloadPreview
Health History Patient Questionnaire R 4 Dec 2023194.65 KB DownloadPreview
Hypertension Clinic Referral 259.46 KB DownloadPreview
IWL- Toolkit Indigenous Wellness Liaison Toolkit73.66 KB DownloadPreview
IWR-ICS-Resources-2021 Indigenous Wellness, Reconciliation and Partnerships Resources516.54 KB DownloadPreview
Interdisciplinary Progress Notes PHC-NF205(R. Oct-09)BC17.85 KB DownloadPreview
Magnetic Resonance Imaging (MRI) Requisition PHC-RA095(R Jun 13-13)print51.83 KB DownloadPreview
Mental Health Wellness Clinic (MHWC) Referral PHC-OP112(R Oct 15-13)BC31.11 KB DownloadPreview
Nuclear Medicine Requisition PHC-NM001(R. Feb-09)248.16 KB DownloadPreview
Older Adult Outpatient Clinic Referral 23Oct2023185.66 KB DownloadPreview
Ophthalmology Surgery Pre-Admission History PHC-OR069(R Sep 15-11)BC31.89 KB DownloadPreview
Outpatient Bone Densitometry Requisition HLTH1905(R 2012-07-25)549.62 KB DownloadPreview
Outpatient CT Requisition PHC-RA091(R Jun 13-13)print36.15 KB DownloadPreview
Outpatient X-Ray Requisition PHC-RA092(R Jun 13-13)print34.74 KB DownloadPreview
Post-COVID-19 Recovery Clinic Referral R. Jul 14-22266.70 KB DownloadPreview
Pre-Admission Information PHC-AD045Oct 19, 2023218.17 KB DownloadPreview
Pre-admission Clinic Anesthetic Consult Request 289.26 KB DownloadPreview
Pulmonary Diagnostics Requisition PHC-RE001(R. Sep 8-2022)BC330.50 KB DownloadPreview
Referral to Pacific Lung Clinic (Fillable) PHC-OP043(R. Apr 6-17)(1)40.30 KB DownloadPreview
Refusal to Accept Transfusion of Blood and or Blood Products PHC-MR031(R Jan 10-13)BC(1)25.34 KB DownloadPreview
Regional Respiratory Referral R. Dec 1-21338.36 KB DownloadPreview
SPH Maternity Centre Postpartum Referral 225.52 KB DownloadPreview
SPH Pain Clinic Referral (Revised 30Aug2023)332.78 KB DownloadPreview
Temporary Substitute Decision Maker - Referral and Identification PHC-MR081(R. Sep 21-11)BC28.04 KB DownloadPreview
Thrombosis Clinic Referral 264.83 KB DownloadPreview
Ultrasound Requisition PHC-RA088(R Jun 13-13)print33.71 KB DownloadPreview